Escondido

TAX SHOCK FROM PPH! A 32% Tax Rate Hike!

2010-07-27T18:55:00.000-07:00

Palomar Pomerado Health is moving forward with a 32% tax rate hike, to $23.50 per 100K of assessed value (AV) from $17.75 per $100K of AV, to cover payments on the Proposition BB bonds approved in 2004.

The PPH Finance Committee passed, without opposition, a resolution recommending the tax rate hike. The recommendation must be approved by the full PPH Board to take effect. The next PPH Board meeting is scheduled for August 9th.

In "calculating" the target tax rate ($17.75), PPH skewed its tax revenue models by excluding years of low AV growth (for example, FY1992/93 to FY1996/97), and by including only years of high AV growth (FY1997/98 to FY2003/04). PPH is now claiming the moderate AV growth since Prop BB passed was "unforeseeable."

Further, PPH has had knowledge of AV revenue issues for several years. As an example, last year: Prop BB Tax Rate Increase Coming Next Year?! (October 03, 2009)

This slide was presented to PPH Board members at a PPH meeting in 2008 warning them of AV revenue issues!

PPH Must Finance An Additional $74M

2010-07-12T15:20:00.000-07:00

Palomar Pomerado must arrange financing for an additional $74 million (for a total of $1,057 million) in order to complete its new hospital. Major factor: the physical plant lease plan was not viable. Other factors: changes and proposed changes totaling about $30 million.

After raiding the funds originally allocated for a new patient tower at Pomerado Hospital, and raiding the funds for renovation of the downtown PMC hospital, PPH is still way short of funds. This is not a surprise to Informed Citizens. PPH had hidden this financing shortfall in plain sight using a purported plan to sell the physical plant for the new hospital and then leasing back its services. No takers were found for this ill-fated plan.

The following report is from 2009: "Yet pressures are also mounting at PPH. After learning the construction costs of its ambitious $773 million 'hospital of the future' in western Escondido had soared far above projections, the district's board was forced in recent months to slash nearly $30 million from the budget, with more cuts possible. Board members must decide whether to outsource a proposed $60 million energy plant to a private firm, . . ." NCTimes, May 28, 2009

In 2008, PPH claimed the lease plan was supposted to save $41 million. (see March 12, 2008)
esco1.blogspot.com/2008_03_01_archive.html

PMC (Lack of) Maintenance Reached Crisis Levels

2010-07-09T21:10:00.000-07:00

This Elevator at PMC had already been down for 1 week according to PPH Staff as of June 18th.

PPH administration is requesting the Board to approve $1,689,750 for a renovation of the Palomar Medical Center elevators. ". . . it has also been determined that the patient tower elevators at Palomar Medical Center are deemed to be in need of renovation and are also an emergent need for use of FY 2011 capital. These elevators service core patient and visitor populations at PMC and thus also meet the definition of strategic imperative. As background, summary of this renovation is as follows:
o Risk of trapped visitors and patients.
o Fire Department being called to respond.
o Doubling workload when one elevator is down."
PPH Board Meeting Packet for 7/12/2010 (pages 40-43)

PPH Testing 3,400 Patients For Risk of Exposure

2010-06-17T13:04:00.000-07:00

PPH is testing thousands of patients that had been exposed to possible infections, such as hepatitis or HIV PPH testing 3,400 patients

Larson Resigns From PPH Board, Yerxa Appointed

2010-05-07T17:59:00.000-07:00

The PPH Board has appointed Steven Yerxa to replace the seat opened by the resignation of Alan Larson. Yerxa was the Chair of the Independent Citizen's Oversight Board when it was first organized. www.pph.org/PPHContentPage.aspx?nd=32&news=87

PPH Creates Arch Health Partners

2010-04-15T08:32:00.000-07:00

PPH has created Arch Health Partners to complete with local medical groups. PPH has loaned $millions to start Palomar Physician Network (aka ARCH HEALTH PARTNERS), a doctor's group controlled by Covert and the PPH Board.

FICTITIOUS BUSINESS NAME STATEMENT FILE NO. 2010-003171 Filed With David L. Butler County Recorder on: FEBRUARY 03, 2010 FICTITIOUS BUSINESS NAME (S) a. Arch Health Partners Located at: 15611 Pomerado Rd. #400 Poway, CA San Diego 92064 Mailing Address: Same This business is conducted by: A Corporation The First Day Of Business Was: 10/01/09 This Business is hereby registered by the following: #1. Palomar Physician Network, 456 E. Grand Ave. #303 Escondido, CA 92025 - California I declare that all information in this statement is true and correct. (A registrant who declares as true information which he or she knows to be false is guilty of a crime.) /s/ Robert Trifunovic, President NCT 2248026 02/07/10,02/14/10,02/21/10,02/28/10

"Acuity-Adaptable" Rooms Legislation Fails

2010-04-10T20:35:00.000-07:00

PPH designed its new hospital to operate on the basis of "acuity-adaptable" beds. (The Hospital of the Future - 168 Acuity Adaptable beds) However, the purportedly "evidence-based" design is not based on much of any real world evidence, and apparently is not a legal mode of operation in California. After completion of the design, and with significant construction under way on the new hospital, PPH has promoted legistration to allow its acuity-adaption mode of operation on an "experimental" basis. The legislation failed. So badly that the hoped for sponsor, Nate Fletcher, pulled the bill from consideration.
Assemblyman pulls Palomar health bill - Plans for adaptable care at new hospital derailed

Over-Budget New Hospital Affects Existing Facilities at PPH

2010-01-25T15:54:00.000-08:00

". . . Michael, are we gonna have another year where we gotta put plastic over on top of the roof at PCCC to keep from having leaks, . . . but when its truly a rainy day, I'd like to fix the roof . . . ."
Quote of PPH CEO Micheal Covert speaking to the PPH Board on October 5, 2009, about the budget for the new hospital.

(Listen to the Audio: PPHBdMtg100509clip.mp3)

A little background. A few years ago, the PPH Board redirected $10 million a year from normal capital expenditures for PPH's existing facitities to cover cost overruns on the new hospital in the ERTC.

That diversion decision was made before the extension was granted allowing continued use until 2030 of the downtown hospital (Palomar Medical Center - PMC). The extension was granted by the Summer of 2008. However, the PPH Board continued the diversion.

The $10 million diversion was shortsighted and should have ended by August 2008, soon after the extension was granted for the existing hospital - PMC!

PPH CEO Gets BIG Raise!

2009-11-22T15:18:00.000-08:00

PPH CEO Michael Covert was given a $154,000 raise by the PPH Board.
ESCONDIDO: Hospital CEO's pay rises to $736K per year, plus possible bonus

The Pomerado hospital expansion has been canceled due to cost overruns on the new hospital, the downtown hospital's renovation has been canceled due to cost overruns on the new hospital, patient care "frills" have been eliminated due to cost overruns on the new hospital, etc.

Covert did not deserve a 26% raise.

The NCTimes Editorial Board disagrees with the Covert Raise:
EDITORIAL: Untenable spiral
Our View: Tying officials' pay to national averages no way to run government
EDITORIAL: Untenable spiral
Our View: Tying officials' pay to national averages no way to run government

Prop BB Tax Rate Increase Coming Next Year?!

2009-10-03T13:26:00.000-07:00

Tax rate to pay for Prop BB bonds may need to be raised. The shortfall for FY2010 is projected to be $500,000. Back in 2004, the PPH promised to charge a tax rate of $17.75 per $100,000 of assessed value.
http://www.pph.org/Media/File/Board_Meetings
/ip_20090810_396.pdf (pdf page 42 of 129)

More Prop BB bonds will be issued in the near future!

Tri-City CEO Doubts PPH Funding

2009-09-23T09:22:00.000-07:00

This was published in the NCTimes:

The new Palomar hospital, he added, is not likely to be finished.
"They're $200 million to $300 million short," Anderson said. "I don't think they can find the money."
Told of Anderson's comments, Covert said his district does have the capital to finish the new building.
"He's obviously not familiar with the specifics of our project and our finances," he said.

HOSPITALS: Local health care landscape changing rapidly

My observation is that PPH's explanations of its expansion programs are not very easy to follow, and appear to have funding gaps.

City Settles Redevelopment Funds Dispute With Schools

2009-08-15T19:00:00.000-07:00

According to the NCTimes, "The city and Escondido's two school districts have reached a tentative agreement for dividing up millions of dollars in revenue from redevelopment property taxes that are expected to accumulate in upcoming years."
ESCONDIDO: Pact divides up future millions from redevelopment

The amounts mentioned in the article are much lower than those proposed in a Spreadsheet dated Oct 12, 1990 showing schools' share.

PPH Schedule Delayed 9 Months!

2009-07-15T21:53:00.000-07:00

PPH has revised the date for the completion of the new hospital to April 2012 from July 2011. This delay has resulted in the need to pay DPR, the project construction managers, an additional $13+ million for their services. PPH has yet to discuss what features of the new hospital will need to be cut in order to make funds available for the additional $13+ million.

City Of Escondido Redevelopment Funds - Transparency Needed!

2009-07-08T14:32:00.000-07:00

Last Fall, I learned that funds from Escondido Redevelopment Agency (Community Development Commission) had been promised to Escondido school districts.

The City failed to provide information to initial public records requests about the promised redevelopment funds in a timely manner. After information was obtained from the school districts, the City then provided information about the promised redevelopment funds AFTER the election was over for Prop T in 2008.

That reaction by the City indicated to me that more transparency is needed with respect to redevelopment funds.

Last March 18, 2009 at a City Council meeting, comments by a Police Union representative about an audit of City funds yielded some interesting comments about the redevelopment funds promised to the school districts.
Comment Video

Based on those comments, the City may be using "loans" to as a mechanism to withhold funds promised to the school districts.

This is what was reported when the Redevelopment Agency was approved back in 1984.

"Redevelopment to aid schools"
Times Advocate, Thursday, December 13, 1984, Page B1
"ESCONDIDO - If the city's proposed redevelopment agency generates as much money over the next 45 years as its proponents say it will, the Escondido Elementary School District could get eight elementary schools, two middle schools and unlimited new classrooms, all paid for with redevelopment money. The Escondido High School District could get three new high schools, two new continuation high schools and more class rooms. Those are some of the provisions contained in drafts of nine different agreements approved 4-0 Wednesday night by the City Council. . . . Approved with little comment, the agreements were negotiated with various agencies that would lose money to the redevelopment agency as it siphons tax revenues from them to pay for a civic and cultural center, downtown improvements and housing assistance for the poor."

Times Advocate, Sunday, November 18, 1984, Page B1
"How much? What agencies would contribute to the cost of redevelopment [in Escondido].
San Diego County $63 million
High school district $51.9 million
Elementary school district $68.3 million
Hospital district $5.8 million "

Oct 12, 1990, EUHSD's share of redevelopment funds = $145 million
Spreadsheet dated Oct 12, 1990 showing EUHSD's share being $145 million allocated by the Escondido Redevelopment Agency for new high school construction and esisting school refurbishment (from link below)

Tax Rate Details and Assumptions (Response from EUHSD to Public Records Request)

~80 page Agreement with Escondido Redevelopment Agency, 1991 & 1984 (Response from EUHSD to Public Records Request)

First response by City of Escondido (NOTHING!) [Second response was a copy of response from EUHSD above]

San Diego County Taxpayers (between $82 million and 254 million - Redevelopment Funds [page 3])

PPH Schedule Delays On New Hospital

2009-07-07T12:15:00.000-07:00

I predict that PPH will soon need to admit to schedule delays on its new hospital.
Page 65 of 70 of the PPH Board Packet for July 13th is telling!

"Prior CM unrealistic schedule" (CM=construction manager).

Translation. The PPH Board does not yet know the extent of the schedule delays because DPR, the new construction managers, have not yet finalized it.

PPH strategy? Blame Rudolph and Sletton, the previous contruction managers!

Who could have predicted that!

Covert to City: MOU May Simply Go Away!

2009-07-06T22:52:00.000-07:00

PPH claims that the Citracado extension to Valley Parkway, which is not due for completion until a decade after the City gets the money for the project, may make the MOU go away!

Listen to the audio (30 seconds) of Covert telling the city (Daniels, Grimm & Domingue) that the MOU may go away. (You will need to turn up the volume).

The NCTimes reported it as if the City is at fault!
Citracado 'connector' delayed to 2013, upsetting PPH officials

There is no delay on the Citracado extension. What is delayed is the Downtown Medical Village promised by PPH to the City of Escondido.

Watch videos of PPH's promises by Marcelo Rivera and Michael Covert and in the MOU for PPH's downtown project. Link to the ERTC Development Dgreement.

Union-Tribune Editorial - More Disclosure on PPH/Kaiser Deal

2009-06-12T12:44:00.000-07:00

Union-Tribune Editorial
More disclosure
Public access needed at Palomar Pomerado Health district
2:00 a.m. June 7, 2009

We are grateful for the time and effort that 19 volunteers (usually retirees) put in every year to serve on the county grand jury. Grateful to them, but certainly not always in agreement with them.

As it did two months ago when it recommended the adoption of a $52.7 million annual trash pick-up fee for San Diego homeowners, while mischaracterizing the nature of the city's pension deficit, the grand jury has gotten another one terribly wrong.

This time, the earnest jurors were bamboozled by the slick talk of the people who run the publicly owned Palomar Pomerado Health district in North County. The issue at hand was the hospital district's insistence that it can keep key details of contracts hidden from the public because they arguably could be used for competitive advantage by private hospital groups. Residents have requested details of a particular deal, but been denied.

The good jurors, according to their report, were satisfied by assurances from district officials that there were no “problems involving public disclosure.” They also reviewed sections of state law and agreed with Palomar Pomerado officials that the law grants them the right to make secret deals. Our reading of those sections suggests otherwise. And, as we have said, if they are ambiguous, the Legislature should rewrite them in favor of the public's right to monitor how elected officials spend tax dollars.

That, of course, is the issue here – the critical importance of open government. One need look only at what problems caused by secrecy have done to the reputation of the neighboring Tri-City Hospital district.

Palomar Pomerado, which serves San Marcos, Escondido, Poway, Ramona, parts of Rancho Peñasquitos and Rancho Bernardo and other areas, is supported by property taxes. In 2004, residents, who elect the district's governing board, voted to increase their taxes for a $496 billion bond issue to fund a new cutting edge hospital in Escondido and other improvements.

Counties, cities, school districts and other government agencies are required to make their revenues, expenses and contracts available for public review. Public hospital districts should not be entitled to any less rigorous scrutiny, despite what a panel of well-meaning volunteers concludes.

In the Union-Tribune on Page F2 (06/07/2009)
More Disclosure Editorial

Grand Jury Opinion of Kaiser Agreement

2009-06-08T16:16:00.000-07:00

"The secrecy surrounding Kaiser Permanente's controversial bed "guarantee" at the new Palomar Medical Center has been appropriate because the health care industry is so competitive, according to a San Diego County grand jury report issued Thursday."

"But Robroy Fawcett, a frequent critic of the district and the Kaiser agreement, said the grand jury does not understand what trade secrets are and has allowed the two providers to define that term too broadly. Fawcett also complained that the grand jury did not contact him or the press. 'They should have asked the people who have been complaining about the lack of disclosure,' he said."

Grand jury vindicates PPH deal with Kaiser (06/04/2009)

Apparently the Grand Jury did not get a copy of these letters from PPH:
Public Records Request Denial Letter #1 (1/30/2006)
Public Records Request Denial Letter #3 (11/26/2007)

For more details on the "trade secret" PPH/Kaiser Agreement from February 2004:
Kaiser Agreement Details

The Grand Jury report makes interesting the timing of this article in the North County Times:
Kaiser contract won't force PPH to turn away other patients (05/22/2009)

Logan Jenkins at UT roasts PPH

2009-05-01T08:09:00.000-07:00

PPH HIRES COSTCO DESIGNER

In yet another signal that the visionary “hospital of the future” is too expensive for today's budget, Palomar Pomerado Health district has retained Costco's interior designer to furnish the rooms of the nearly billion-dollar hospital.

After having dropped an outdoor healing garden, meditation room and a $3 million “media wall,” the district's board voted to save more money by adopting a wall-less warehouse design concept.

“It may not be what we promised, but we're planning to sell Hebrew National hot dogs out front,” said Michael Covert, the health district's president and CEO.

LOGAN JENKINS, 03/15/2009

No Covert Bonus

2009-04-18T19:06:00.000-07:00

"PPH president and CEO, Michael Covert, has been denied any bonus this year because of the district’s failure to meet performance standards. Bruce Krider, Chairman of the PPH Board, said that even though Covert has received heavy bonuses for the past four consecutive years, he won’t be getting one this year."

The Paper, 04/09/2009

Stay Informed!

2009-04-01T07:10:00.000-07:00

The local newspapers have quit covering much of the latest news at PPH.

Stay Informed. Subscribe to INFORMEDCITIZEN on twitter.com
http://twitter.com/informedcitizen

Stay Informed. Watch the InformedCitizens on YouTube.com
http://www.youtube.com/user/InformedCitizens

Coming topics:
1. Bonus results for PPH CEO Michael Covert (April 1st meeting).
2. 10 month freeze on new equipment at Palomar Medical Center.
3. Continuing DPR contract negotiations. In its 10th month!
4. Kaiser contact details. Deadlines and financial penalties.
5. PPH's March strategy meetings (8 hours). Topics:
- Expansion out-of-district into Temecula, Oceanside, Carlsbad
- Proposed takeover of Graybill & CHC by PPH-controlled & funded

Facebook group coming soon!

Why twitter, youtube, blogger, facebook, etc.
Experts predict the end of the printed local newspaper business model.
http://escondido.ning.com/

Covert Bonus On April 1st!?

2009-03-30T13:08:00.000-07:00

It sounds like an April Fool's joke! The PPH Board is considering a bonus for Covert AFTER a year in which the Medical Village in downtown Escondido was neglected, the Pomerado Hospital Expansion funds were diverted, and the budget for new ERTC/Kaiser hospital budget continues to spiral out of control! Here the agenda for the "special" meeting! http://www.pph.org/Media/File/
Board_Meetings/spbm_20090401_289.pdf

The PPH Board may be really out of touch with the current economic situation. The latest Finance Committee report shows PPH making only $3,296 in February, before property taxes were factored in. http://www.pph.org/Media/File/
Board_Meetings/ip_20090331_288.pdf (pdf slide 86 of 129)

Is PPH headed into the "AIG" zone!

DPR Contract "Hides" Known Increases

2009-03-29T22:19:00.000-07:00

The "new" DPR contract has significant potential for later cost increases. The proposed contract has a baseline amount for DPR of about $43.1 million "based on an estimated Substantial Completion Date of July 1, 2011." [Section 5.2] If the Final Project Schedule indicates that the completion date will be later, then DPR compensation is increased.
http://www.pph.org/Media/File/
Board_Meetings/ip_20090331_288.pdf (pdf slide 42 of 129)

The Final Project Schedule from DPR is not due until July 1, 2009! [Section 2.4.4]

Referring back to the schedule I analyzed in my post below on May 14, 2008, the start of the steel structure was delayed from July 1, 2008 to mid-November, a 4 1/2 month delay. I believe it would be extremely difficult to meet the "estimated" completion date of July 1, 2011, given the already known delays. Further, numerous statements from PPH officials have placed the completion date well into 2012.

A year ago, this change was supposed to save money for PPH:
"Eight months after it broke ground on its new hospital, Palomar Pomerado Health is preparing to change construction managers in hopes of shaving up to $50 million off the cost."
PPH to change contractors on hospital construction project

It is quite interesting how the North County Times and the Union Tribune continues to print whatever fiction PPH feeds them!

PPH Update by Jim Vander Spek

2009-03-22T18:53:00.000-07:00

Jim Vander Spek writes another insightful letter:

The latest news out of PPH is not encouraging. After Prop BB was passed and this agency announced that a new site in the boondocks was chosen for the new hospital, many predicted that their facility plan was taking on the appearance of a slow moving train wreck. That is now coming true.

Most recently, our local daily newspaper reported that the new ERTC hospital is costing roughly twice what Sharp is paying for their similar sized facility in San Diego. The PPH bond rating has been lowered, and operating results have turned negative.

The new hospital will be outrageously expensive but also sadly deficient. For example, it will not house a woman’s health facility because funds ran out. Further cutbacks on “frills” have also been announced.

Promised clinics in San Marcos, Valley Center and even Ramona are doubtful or abandoned. As for the downtown Escondido improvements, we can forget about that. Only a clinic near Rancho Bernardo has materialized, probably to staunch the bleeding from inroads that Scripps Hospitals is making in that area.

All of this could have been avoided if PPH had stuck to their original plan of using taxpayer moneys to expand and modernize the Escondido site. It would have been done by now and a jewel for North County. Instead, in order to meet the facility needs of Kaiser Hospitals, we have what we have, if they indeed can even finish what they started.

http://www.thecommunitypaper.com/
archive/2009/03_19/letters.php
A special THANK YOU to Lyle Davis of THE PAPER for his work in shining light on the Covert Operations at PPH!

PPH's Ultra Expensive Hospital of the Future

2009-03-15T15:48:00.000-07:00

"The hospital of the future' being built in western Escondido is projected to cost $934 million, more than four times as much as a $194 million 'hospital of the future' that opened last month in San Diego."
Timing, land costs make new hospital more expensive than SD facility

FOUR TIMES AS MUCH! PPH is frittering away taxpayer funds, and is continuing to neglect the downtown facility.

PPH Board Blindsided by Covert Cost Increases

2009-03-10T19:24:00.000-07:00

The PPH Board member never ask probing questions of PPH CEO Michael Covert. For that reason, Covert has again blindsided with further cost increases on the new hospital.

"Hospital trustees said they were surprised the transition costs had not been included in previous budgets, and Trustee Nancy Bassett urged district staff members to avoid handing trustees large bills at the last minute."
Transition costs for new hospital may be $20M [North County Times]

Cost Cuts Plague New Hospital

2009-03-08T14:36:00.000-07:00

The costs for PPH's expansion plan have spiraled out of control until it hitting a ceiling of implausibility. PPH cannot hope to raise enough money to complete the "Hospital of the Future" as presently configured. The present configuration has had numerous cuts over the years, but now the PPH Board members are being forced to cut pet features.

"The $21.4 million in cuts approved Monday include eliminating water features, an outdoor playground, several gardens, a library, meditation room, conference center and a large electronic drape that would display soothing images. "
Trustees cut $21M in features from new Escondido hospital [North County Times]

As long as the present administration continues, these features (and more to come) will be gone forever!

Scripps Opens In Escondido

2009-01-21T12:30:00.000-08:00

Scripps Coastal Medical has acquire the Penn/Elm Medical Group in Escondido, having offices across the street from Palomar Medical Center.
Scripps Coastal Medical Center opens in Escondido [North County Times]

I have heard several persons in the Escondido community speculate that PPH's new hospital was part of a strategy to prevent Scripps and Sharp from making incursions into PPH's markets!

A government hospital district using tax money to prevent competition in area medical care services. If true, it would be unfortunate for district residents.

PPH Hides Cost Increase Meeting

2009-01-09T11:18:00.000-08:00

I was surprised to read a very informative article about last night's special meeting by the PPH Board of Directors.
PPH may scale back new hospital to rein in sharply rising costs (North County Times)

In a letter I sent to PPH on March 29, 2008, I requested to remain on the list to receive notification of all PPH Board meetings. I did not receive any notification of last's night meeting about the update to the PPH Facilities Master Plan

If I had known about the meeting, I would have certainly been there to videotape it.

Bond Funding Delayed

2008-12-05T17:09:00.000-08:00

PPH decided to delay issuance of both ARS revenue bonds reissuance and GO (Prop BB) bond issuance because of market conditions on Wall St.
http://www.pph.org/Media/File/
Board_Meetings/min_20081202_238.pdf
[pdf page 4 of 32]

Election Fails To Change PPH Board

2008-11-15T20:02:00.000-08:00

The incumbent won re-election. The 2-year open seat was won my Jerry Kaufman, who was past member of the ICOC, before resigning for an apparent conflict of interest, and who stated during that Candidate's Forum that he was on a "Chairman's Council", whatever that is. Thus, no significant change to the PPH Board.

Fitch Ratings: PPH May Be Required To Increase Property Tax Rate

2008-10-24T08:32:00.000-07:00

The PPH Board just voted to issue $110 million of Prop BB authorized bonds two years ahead of schedule. The original schedule for the third issuance of Prop BB bonds was in FY 2011 as shown in this slide presentation from July 29, 2004 (slides 18-19, pdf pages 20 & 21 of 25). http://civics.robroy.cc/PPHFinancePlan080404.pdf

The projected tax rate for paying for the Prop BB bonds was based on a later third issuance, AND on a property tax base that grows at an average of 6.1% per year between FY 2005 and FY 2046. Much of the PPH district has experienced a collapse in real estate values on the order of 30 to 50%, which collapse will likely translate into a shrinking tax base. No credible estimates have the property tax base growing by 6.1% for the foreseeable future.

I am convinced that the accelerated issuance of these bonds, the recent collapse of real estate values, and the current slowdown in PPH revenues, makes it mathematically impossible for PPH to maintain the promised tax rate of $17.75 per $100,000 of assessed valuation promised to the voters in 2004.

The requirement for the PPH Board to raise the property tax rate is echoed by Fitch Ratings in its just published (October 21, 2008) evaluation in advance of the accelerated issuance of $110 million of Prop BB bonds:

"The tax rate and levy to repay debt is unlimited, although PPH is legally required to pay the general obligation debt if the ad valorem taxes are insufficient. Fitch notes that the tax base vulnerability may require PPH to exceed the tax rate promised to voters in order to accommodate the rising debt service schedule."
marketwatch.com: Fitch Rating Article
digital50.com: Fitch Rating Article

The accelerated issuance of $110 million in bonds is covering for PPH's inability to issue additional revenue bonds at this time. The two main reasons for not issuing revenue bonds at this time: 1) PPH failed to generate sufficient revenues in FY 2008 to now support an offering for additional revenue bonds; and 2) PPH must now refinance variable rate revenue bonds issued in 2006 ($180 million) which have interest rates set in weekly auctions held by Citigroup, and those interest rates have doubled during to the current financial crisis.

Based on my calculations, I am certain that property tax revenues at the tax rate now being levied ($17.75/100K) will not cover the required debt payments for the Prop BB bonds being issued. The question now is, will the PPH Board vote to raise the tax rate, or will the PPH Board cover the shortfall with its own funds. I find it highly doubtful that the PPH Board will vote to cover the shortfall with its own funds. PPH does not have the funds to cover a property tax shortfall. That being the case, then the current PPH Board just took an action that will result in higher future property taxes on the average property owner in the PPH district.

A stealth property tax increase by the current PPH Board!

Palomar Medical Center has been SAVED!

2008-08-30T20:58:00.000-07:00

Palomar Medical Center, the heart of downtown Escondido, has been saved! Citizens for a Downtown Hospital are to be congratulated for keeping the public aware of the true condition of PMC.

"State regulators have pushed back the deadline for Palomar Medical Center in Escondido to meet new earthquake-resistant building standards from 2013 to 2030."
NCTimes: Deadline Extended to 2030

I have maintained that Palomar Medical Center needed only modest retrofits to meet State earthquake standard until 2030. Now the State of California, using a computer modeling program, has determined that even those retrofits are not needed, thus extending the life of Palomar Medical Center by two decades.

The current PPH administration exaggerated the problems with Palomar Medical Center in order to get taxpayer funding for an expansion required by a "trade secret" deal with Kaiser. The current PPH adminstration and board will be long gone before there is any opportunity for PPH to implement its wrong-headed decision to close the downtown Emergency Room, and other vital acute care resources. Thus, Palomar Medical Center has been SAVED!

Back in 2000, before the current PPH administration wandered into town, the cost of retrofitting the McLeod tower was a modest $3 million to $6 million. "'We're marching through the hospital stem to stern, looking at every square foot to decide what our future needs will be,' said David Owen, spokesman for the Palomar Pomerado Health System, which encompasses the 333-bed Palomar Medical Center in Escondido and the 199-bed Pomerado Hospital in Poway. Pomerado is in good shape. But there are two unsafe buildings at Palomar Medical Center, including the tower that houses a large number of hospital departments. McLeod Tower, built in 1967, will take by far the most amount of work ---- $3 million to $6 million, officials estimate. The tower ---- highly recognizable to passers-by ---- is in the center of the complex and could be considered the hospital's nerve center. It houses surgery rooms, oncology, radiology, mental health, pediatrics, orthopedics and the Graybill Auditorium. The Adams wing, built in 1957, houses administrative offices and is expected to cost $400,000 to retrofit. The problem, hospital officials say, is the non-construction costs, which have yet to be determined. Depending on how intensive the repairs are, those can include the costs of closing whole units and relocating patients, the costs to move expensive machines and the costs to build temporary housing for the displaced patients, doctors and machinery. 'The basic cost of construction is relatively minor compared to what other hospitals have to spend,' Owen said. 'But we have no way to guess what other expenses we are talking about. It might take $3 million to fix the wall, but another $3 million to $4 million to move all the X-ray stuff.' It's all going to take money better spent on program and patient care, hospital officials said."
NCTimes Article from 2000

PPH Board Election

2008-08-26T18:52:00.000-07:00

A number of challengers have signed up to run against the present PPH Board. A new vision at PPH is sorely needed.

Challengers include ex-San Marcos Councilman Lee Thibadeau, and past-PPH Board member Evelyn Madison
NCTimes: PPH Race Attracts Candidate

PPH Layoffs: Chaplains Cut

2008-07-30T19:45:00.000-07:00

It appears that PPH's costly new hospital is affecting care at the existing hospitals.

"Some Palomar Pomerado Health employees said this week they're worried that recent layoffs that cut Palomar Pomerado Health's number of staff chaplains could leave some people without the spiritual support they need."
NCTimes: LIFE SUPPORT

Lawsuit at PPH

2008-07-26T17:34:00.000-07:00

A doctor sues PPH, and CEO Covert, over the termination of his right to practice at any PPH facility. Read the full story at:
The Paper: The Covert Agenda

A watered down version:
Doctor Sues Hospital

PPH them terminates a long-term contract with the Doctor's Radiology Group.
NCTimes: Radiologists protest cancellation of contract with PPH

UT: Full Airing, Please

2008-07-01T09:40:00.000-07:00

The San Diego Union-Tribune
Monday, June 30, 2008, Page B6

Full airing, please
Palomar Pomerado pact shouldn’t be hidden

The publicly owned Palomar Pomerado Health District wants the best of both worlds. It wants to keep contracts hidden from the public to protect trade secrets that arguably could be useful to a private hospital group seeking to compete with the district, which serves San Marcos, Escondido, Poway, Ramona, parts of Rancho Bernardo and Rancho Penasquitos and other areas.

Yet the district enjoys the taxing and bonding authority of a public agency. Most recently, in 2004, voters passed Proposition BB, a $496 million bond measure to fund expansion and improvement of district facilities, including a state-of-art hospital now under construction in Escondido. As a result, property owners are paying an additional $17.75 for every $100,000 in assessed valuation annually for 30 years.

The fundamental fact that Palomar Pomerado is owned and partially funded by taxpayers trumps all arguments about why it should be allowed to keep contracts secret.

The issue has come to a head over efforts by some district residents to see details of a Palomar Pomerado contract with Kaiser Permanente guaranteeing a certain number of beds in the new hospital to patients insured by Kaiser, in return for unspecified payments from the health insurer. The district has released a copy of its contract with Kaiser, but the document is so heavily redacted that it is impossible to glean details.

In addition, top Palomar Pomerado officials implausibly deny that a guarantee exists, though unredacted sections contain the words “capacity guarantee,” “guaranteed bed” and more. Almost surreally, the officials insist that skeptics among the public and inquiring journalists are taking the words out of context. That context, they note, apparently unaware of the irony, is in the portions of the contract they redacted.

One top official, while insisting there is no guarantee, did at least acknowledge that the contract does provide Kaiser with a “certainty” of available beds in exchange for a fixed payment. [Compare: " a fixed payment for bed availability guarantees", PPH2WallSt103007.pdf , discussed in my blog entry of April 26, 2008]

District taxpayers have every right to question whether the deal with Kaiser is good for residents, and whether it might have affected voters’ thinking during the Proposition BB campaign. But the Kaiser contract is really just a symbol in the bigger, and essential, discussion of the importance of open government.

The revenue, expenses and contracts of Palomar Pomerado - and all public hospital districts - should be subject to detailed public review, just as are those of counties, cities, school districts and other government entities. That is one way elected officials are held accountable and waste or corruption detected. Sunlight and fresh air are the best disinfectants.

District officials point to sections of the Health and Safety Code that they say give them the right to make secret deals. Our reading leads us to conclude otherwise. If the law is-ambiguous, the Legislature should change it in favor of taxpayers and their right to monitor how government manages their money and resources.

In the meantime, we call on the Palomar Pomerado trustees to do the right thing and expose the details of Kaiser bed guarantee to the air and the light.

San Diego Union Tribune: Full airing, please

2008-06-30T13:28:00.000-07:00

The Editors at the Union Tribune wrote: "In the meantime, we call on the Palomar Pomerado trustees to do the right thing and expose the details of the Kaiser bed guarantee to the air and light."
June 30, 2008, page B6

Union Tribune Covers Concerns of Informed Citizens

2008-06-27T21:09:00.000-07:00

The Union Tribune has two articles about the cost overruns for the new hospital, the funding cuts to the downtown Medical Village project, and secretive Kaiser Agreement.

The 'new hospital will have 300 beds, not 453', and the downtown project budget of '$73 million . . . is down to $20.8 million for two warehouses and buying three properties - none of it to pay for the healing gardens, pedestrian pathway, stone-covered buildings and magnet high school the district talked about in detail in 2005'
SD Union Tribune: Costs Cloud Vision

Regarding an agreement to set aside "about one-third of the 300 beds" in the new hospital "for patients of Kaiser Permanente", PPH lawyer claimed the Kaiser agreement was protected from public disclosure because of "trade secrets".
SD Union Tribune: District defends guarding details of Kaiser contract

"Quiet" Layoffs at PPH

2008-06-26T22:55:00.000-07:00

PPH is laying off 67 full-time employees and 19 part-timers to reduce overhead costs. PPH currently has 2,663 full time employees.

More is available at:
NCTimes Article: PPH Layoffs

The Secret Kaiser/PPH Agreement (Redacted!)

2008-06-02T07:31:00.000-07:00

The Paper recently forwarded a redacted copy of the secret Kaiser Agreement to me. I have since found out that other media outlets had received copies of the secret Kaiser Agreement before The Paper received it in response to the public records requests, namely the North County Times in February, and the Union Tribune in April. Neither the NCTimes nor the UT have reported on the secret Kaiser Agreement.

PPH has refused to provide me with any part of the Kaiser Agreement for over 2 years!
http://civics.robroy.cc/PPH-KAgmtDenial1.pdf January 31, 2006.

The redacted secret Kaiser/PPH agreement is available at this link:
http://civics.robroy.cc/ka.html

To date, the Paper is the only media outlet to inform the public of the redacted secret Kaiser Agreement:

"Redacted Kaiser/PPH Agreement Released
In response to a recent public records request made by The Paper, Palomar Pomerado Health has provided a redacted (blacked out) version of a Hospital Services Agreement between Kaiser Foundation Hospitals and Palomar Pomerado Health effective February 1, 2004.
The 4-year old Kaiser/PPH Agreement is 73 pages. About 12% of the Kaiser/PPH Agreement was redacted. An attached set of Appendices includes an additional 60 pages. About 58% of the Appendices was redacted. A copy of the Kaiser/PPH agreement is available on the web at: http://civics.robroy.cc/ka.html

The details of the Kaiser/PPH Agreement will be reported after more study of this information and will be published in The Paper, when completed."

The Paper, May 29th, 2008

Interesing parts of the Kaiser/PPH Agreement:

15.7 Consultation andCooperation
The parties shall consult with each other regarding any issue pertaining to the Agreement which causes media interest or a party's concern about public relations, and the parties shall cooperate in developing any statement or press releases in connection with any such issue. . . .

8.10.2(c) If the Receiving Party . . . is requested (by . . . requests for public records under Government Code § 6250 et seq., . . . ) to disclose any Confidential Information, that party shall . . . give the other party prompt written notice of the request . . . at least forty-eight (48) hours prior to making such disclosure, so that the other party may seek a protective order . . .

2.6 Capacity {Completely Redacted}
7.6 PMC Expanded Facilities Design {Completely Redacted}
7.7 Clinical and Administrative Office Space Leasing {Completely Redacted}
7.8 Additional Facilities {Completely Redacted}

PMC West / Kaiser Hospital Schedule Slips

2008-05-14T20:49:00.000-07:00

PPH is "hoping" to save $50 million by changing General Contractors for the new PMC West / Kaiser Hospital in the ERTC. Wow! Good luck with that!
PPH to change contractors on hospital construction project

To the side is a comparison of construction schedules for the new PMC West / Kaiser Hospital provided by PPH in 2004, 2006, and 2008. It appears that the schedule for the new hospital in the ERTC slips a week every two weeks. According to the original schedule in 2004, the scaled-down hospital project is about 2 years behind schedule.

Last December, PPH CEO, Michaal Covert, addressed the Downtown Business Association Board in Escondido. "Covert said plans have always called for work on Palomar's patient wings and other buildings to be started only after the new hospital opens in late 2011 or early 2012."
PPH official seeks to reassure downtown business leaders

The "early 2012" move-in date was reported in an article last October: "The new hospital is expected to relieve some of the pressure on Palomar, but that is not scheduled to happen until early 2012."
Rapid medical evaluation

Interestingly, PPH did not mention the schedule slips as one of the reasons for changing the general contract in the middle of the hospital construction project.

Shame On NCTimes: "Kaiser's Secret Dream Comes True"

2008-04-26T21:14:00.000-07:00

Last Thursday, I tried to post a comment on this North County Times article: Palomar Pomerado pours concrete for new hospital.

Here is the comment that was not posted:

"Kaiser's Secret Dream Comes True"
"About a third of this new hospital is for Kaiser. PPH has an agreement with Kaiser that PPH has characterized as a trade secret. However, to convince Wall St. to support its bonds, PPH wrote the following last fall, 'Under the Kaiser Agreement, the District is obligated to provide inpatient and outpatient hospital services, primarily at the new PMC hospital, to Kaiser for members of the Health Plan in exchange for fees based upon a schedule the parties have negotiated including a fee for services rendered per diem and a fixed payment for bed availability guarantees. . . . After the District completes and opens the new Palomar Medical Center Campus, the District will be required to provide Kaiser a guaranteed hospital bed capacity. . . . After opening the new PMC hospital, Kaiser will be required to make certain fixed payments to the District. . . . the District has the right of first opportunity to negotiate with Kaiser to develop or participate with Kaiser in developing (at Kaiser's election) any general acute care hospital Kaiser proposes to develop in the District's service area.' The Kaiser agreement was approved in January 2004! It reality, the PPH-Kaiser agreement has been a big political secret!"

Why was my comment not posted? Perhaps my quoting from a PPH document violates the comment editor's policy against: "offensive language, defamatory statements, personal attacks or other questionable content."

My comment was well researched and should have been posted. The PPH document I quoted from is available on my website, 1). Also available are a first denial letter from PPH in which PPH characterizes the Kaiser Agreement as a trade secret not subject to public disclosure under the California Public Records Act, 2); a PPH document projecting Kaiser's need for 137 beds in 2015, 3); a document indicating that the new ERTC hospital will have 300 usable beds, and 60 "shelled" beds needing funding for completion, when the new hospital opens, 4); and a recent denial letter from PPH dated 11/26/2007, 5). The PPH-Kaiser Agreement was approved on 01/20/2004, which was 9 months before the $496 million Proposition BB was submitted to the District's voters, 6).

1) PPH2WallSt103007.pdf
2) PPH-KAgmtDenial1.pdf
3) KBedNeed.pdf (page 9)
4) PPHBdSupport122005.pdf (page 22)
5) PPH-KAgmtDenial3.pdf
6) KaiserInfo2004.pdf

Shame on the North County Times for keeping the community in the dark on the PPH-Kaiser Agreement!

Escondido Mayor Bans Citizen's Video Presentation

2008-04-15T18:56:00.000-07:00

The Mayor of Escondido, Lori Holt Pfeiler, went to silly lengths to prevent the video presentation of Escondido resident Wally Gutierrez.

More discussion of what happened may be presented when time is available!

Here is the video of the promises made by then PPH Chair Marcelo Rivera that he wanted to present: Rivera Video

What is really troubling is the the video was presented at the previous meeting (the Mayor was absent), but the sound did not work, and the citizen was invited to return at the next meeting.

Videos of the Mayor's silly actions in quashing citizen advocacy:
Part 1
Part 2
Part 3
Part 4

The story in the NCTimes:
Before Story
After Story

NCTimes editorial favoring multimedia presentations:
NCTimes Editorial

"The Paper" is Banned By PPH

2008-04-02T18:42:00.000-07:00

Lyle Davis publishes "The Paper" a weekly distributed in San Diego's North County region. During the preparation of an article focusing on PPH's CEO, Michael Covert, Lyle Davis was informed that his paper was no long allowed to distribute copies at Palomar Medical Center and at Pomerado Hospital.

Articles on the ban:
The Paper Banned Article (bottom of the page).
The SD Union Tribune and PPH spin the ban:
Biased Union Tribune Article

The offending article: "A Covert Operation . . ."
www.thecommunitypaper.com

Auction Rate Securities Bite PPH

2008-04-01T18:14:00.000-07:00

In 2006, PPH refinanced bonds, and issued new bonds. These bonds were auction rate securities having an interest rates determined by weekly auctions held by Citigroup. The ARS scheme was supposed to provide provide PPH with short-term interest rates for long-term bonds.

Instead, PPH's borrowing costs have doubled or even tripled! Further, PPH and Citigroup entered into an interest-rate swap derivative to partially protect from high interest rates, but since interest rates have dropped, PPH owes Citigroup money from the low interest rates!

Moodys has lowered PPH's outlook because of the exposure.
www.thecommunitypaper.com

"Extreme instability in that area ---- called auction rate securities ---- in the last five weeks has raised interest rates on about $180 million in debt that Palomar Pomerado is carrying from an average of 3.79 percent to as high as 10 percent."
NCTimes Moodys Article

I wonder if Citigroup informed the PPH Board that Citigroup was fined 1.5 million by the SEC in 2006 for violative practices in its auctions.
SEC Press Release

Videos of PPH's Empty Promises

2008-03-31T19:54:00.000-07:00

An Informed Citizen Concerned About The Downtown Hospital has generated videos from past City Council meetings to highlight the promises made by PPH to create a destination Medical Village in downtown Escondido, as part of the agreement to allow PPH to build a hospital in the ERTC across the street from SDGE's 550 Megawatt electric power plant.

The videos can be viewed on www.youtube.com. Search for videos posted by the InformedCitizens.

Here is a link to the video of the promises made by then PPH Chair Marcelo Rivera:
Rivera Video

Here is the video of the promises made by PPH CEO Michael Covert:
Covert Video

Funding Shortfalls and Priorities at PPH

2008-03-12T21:22:00.000-07:00

Look at PPH's 32 acre ERTC medical campus. After $811 million is spent, the campus will sport big parking lots, a big vacant field, and an 8 acre hospital facility.

PPH will have numerous high-priority projects needing funding. These projects include the Women's Center (93 beds), the Hospital Support building, the Outpatient services building, the North Nursing Tower expansion (~150 beds), and several parking structures. However, PPH's financing is so tight, it is considering leasing its Physical Plant (Mechanical) facilities! This is hailed as a $41 million savings!

Further, the expansion patient tower at Pomerado Hospital will be 83% shelled, after spending $117 million. Why would PPH cut $72 million from the funding of the downtown Medical Campus, but fund a building that will be only 17% complete! Poway must hold more political sway than Escondido! And Escondido has an MOU with PPH!

The handout provided to the City Council is available at this link:
CChandout031208.pdf

The picture of the Master Plan map and the Finance-Constrained Plan map are available at this link:
CChandout031208.jpg

Where Is The Schedule for PPH's Destination Medical Village In Downtown Escondido

2008-03-05T21:52:00.000-08:00

PPH claims it is going to create a destination Medical Village in downtown Escondido. The current plan would require the closing of Valley Boulevard (the current location is shown by the blue lines). An EIR has not been prepared for such action.

Further, PPH claims it will build a 50,000 sq. ft. class A office building for its new headquarters. Where will that headquarters building be located. I have circled two buildings. A request was made through the City Council for the ill-advised "secret" Hospital Ad Hoc Committee to request a schedule from PPH for the two circled building. I predict that the Ad Hoc Committee will fail in this task.

The handout given to the City Council is available at these links:

PMCEast-Sched030508-1.JPG

PMCEast-Sched030508-2.JPG

PPH's full plans are available at this link under August 20, 2007:

http://civics.robroy.cc/PPHFG.html

Link to PowerPoint presentations:

PMC-East 8-20-07.ppt (29 MBytes)

PMC-East 8-20-07.mht (41 MBytes)

New "Secret" Ad Hoc Hospital Committee Opposed

2008-02-10T19:24:00.000-08:00

The City of Escondido formed a "Hospital Ad Hoc Committee" to work with the Palomar Pomerado Hospital District regarding the ERTC and downtown development agreements and the MOU. I believe the Ad Hoc Committee meetings should be open because PPH is a necessary party to the meetings, and because the ad hoc committee will be a standing committee having continuing subject matter jurisdiction. Under CA Govt Code 54952, the ad hoc hospital committee would be a "legislative body" subject to the open meeting requirements of the Brown Act.

First page of handout given to the City Council.
http://civics.robroy.cc/Handout020608adhoc1.pdf

The MOU does not require PPH to build anything downtown. Instead, it merely requires PPH to move its administrative headquarters to the downtown campus two years after the new hospital opens.
http://civics.robroy.cc/MOU-AdHoc.pdf

The final MOU is available at this link:
http://civics.robroy.cc/final-mou.pdf

Possible Small Hospital Planned for San Marcos

2008-02-04T10:12:00.000-08:00

H.G. Fenton is proposing to build a University Office and Medical Park on Discovery Street in San Marcos. This is just west of CSU San Marcos.
http://www.signonsandiego.com/news/northcounty/20080202-9999-1mi2fenton.html

The plan includes a healthcare facility and/or smaller scale hospital. The "Initial Study" shows 80,000 square feet of hospital space, and 250,000 square feet of Medical Office/Hospital space. The total size of the Hospital, Medical Office, and Professional Office space in the project would be 1,070,000 square feet! (Initial Study, page 4)

The plan's Initial Study and EIR are available at:
http://www.ci.san-marcos.ca.us/departments.asp?id=5265

SB306 Extends Deadline For SPC-1 Buildings To 2020

2008-02-03T09:40:00.000-08:00

OSPHD has recently posted information about SB306 on its website. http://www.oshpd.ca.gov/fdd/sb1953/index.html (Near the bottom of the page under "Legislative Changes.")

The legislation was approved by the Governor on 10/13/2007. The bill:
1. Permits a hospital owner to comply with seismic safety deadlines and requirements in current law by replacing all of its buildings subject to seismic retrofit by January 1, 2020, rather than retrofitting by 2013, and then replacing them by 2030, if the hospital owner meets all of the following conditions:
A. The hospital owner has requested an extension of the 2008 and 2013 seismic safety deadlines.
B. OSHPD certifies that the hospital owner lacks the financial capacity to meet seismic standards, providing the hospital owner provides specified financial information to OSHPD by January 1, 2009, including information filed annually with OSHPD that shows that the owner meets all of the following financial conditions: [Cannot afford to retrofit, and maintains Medi-Cal contract and a list of items. See the legislation for details.]
2. Permits OSHPD to approve extension of the deadlines for a hospital that is classified as a nonconforming Structural Performance Category (SPC)-1 building, and is owned by a county, city, or county and city, that has requested an extension of the July 1, 2008 deadline to file a declaration by June 30, 2009, if the owner files a declaration with the office that as of the date of that filing the owner lacks the financial capacity to meet the January 1, 2008 deadline for that building. Requires the declaration to set forth the commitment of the hospital to replace those buildings by 2020 with other buildings that meet SPC-5.

This appears to be the reason why the conditions for re-evaluation using the HAZUS software have changed! The re-evaluation to SPC-1E was not needed!

It just may be that the life of the McLeod tower at Palomar Medical Center was extended to 2020 by SB306! PPH is a public hospital district, and it may not fall under item 2, but it would be surprising if it did not fall under item 1.

The legislative history is available though: http://www.leginfo.ca.gov/bilinfo.html

The bill was first introduced 2/16/07 , and approved by the Governor on 10/13/07.

PPH was tracking the bill: http://www.pph.org/default.aspx?nd=1074.

Fact Checking For: Vibrant Downtown Medical Village At Risk

2008-01-31T08:13:00.000-08:00

The North County Times ran an article written by Wally Gutierrez and myself, "Vibrant Downtown Medical Village At Risk":
http://www.nctimes.com/articles/2008/01/27/
perspective/8_34_561_26_08.txt

We have received inquires as to whether the article is accurate.

The facts in the article were checked as shown by these two emails:
Fact Checking Email 01/17/2008
Fact Checking Email 01/18/2008

The emails are in Outlook Express format. It is best to save the emails by right clicking and using "Save Target As..." Then the emails can be opened with access to the attached pdf documents.
(If this too problematic, I can convert the emails to pdf and provide links to the attached pdf's)

The Latest New Hospital Design

2007-12-18T19:02:00.000-08:00

The medical campus for PPH's "Hospital Of The Future" is turning out to be quite compact. Gone from current plans (for lack of funds) are the Hospital Support Building, the Women's Center, the Outpatient Services Buildings (2), and the Parking Structures (3). Instead, the campus has been reduced to a hospital having a tall 12-story Nursing Tower connected with a two-story Diagnosis & Treatment building, and a separate Central Plant building. Much of the remaining area consist of circulation roads and parking lots.

The Nursing Tower and the D&T building will sit on about 7 acres of land. The Central Plant will sit on about 2 acres. A garden will cover about 2 acres. That is only 11 acres! The two parking lots would cover 10 acres.

This scaled back plan is now projected to cost $$773 million! That is $773,000,000.00

A future hospital expansion tower, if ever built, would sit on about 2 acres of land. On the south end of the site, 6 acres have essentially dropped off the map, presumable for future medical office buildings. That development is distant at best.

PPH exaggerated its land needs, in terms of acreage, during the search for an alternative to the current downtown hospital location! Further PPH over-hyped the "healing environment" concept for the new medical campus:

"The location and spatial allocation of the inpatient units will be predicated by the planning objective of creating a healing environment (patient rooms that have nice views with a connection to nature and landscape). Ideally, the inpatient units should be organized in a series of lower scale structures (3 to 5 floors in height) in order to maintain the connection to landscape and to avoid the image of an imposing institution. Also, if possible, the inpatient units should be located in a sector of the campus that is relatively quiet and removed from the entry/arival areas of service and patients/visitor." Facilities Master Plan of 2004, page 1-21.

http://civics.robroy.cc/PPHMasterFacilityPlan07-2004p300.pdf

It is hard to image a hospital design that more fully fails to meet any of the objectives of the quoted paragraph than PPH's current design for the "Hospital Of The Future"!!!

In a recent meeting, PPH Board member Dr. Alan Larson stated that he felt it would have been "disaster" if PPH had gone forward with an earlier plan to build a 9-story tower at the existing downtown site.

Ink By The Cartridge

2007-11-23T17:08:00.000-08:00

Interest in the ERTC rock crushing and soil remediation issues has been so high, Wally has had to make several runs to the local office supply store to purchase ink cartridges for printing out copies of documents received in response to his recent requests for public records.

To help Wally save ink, I am posting copies of the documents received. This is the "raw" response, i.e., a copy of the packet as received to date.

The first packet was received from the City of Escondido in response to a request made on October 8, 2007 for:
1. All documents (such as correspondence) about request(s) for bid or proposal regarding the grading or recompaction of PPH's ERTC site.
2. Documents (such as correspondence) related to geotechnical analysis of PPH's ERTC site including soil compaction tests, grading fill analysis, core samples, soils reports, etc.
3. Correspondence (such as letters to or from PPH, JRM-ERTC or OSHPD) related to the suitability or feasibility of placing a new hospital on the pad at PPH's ERTC site.

The City produced a stack of documents about 6 inches high. These documents were selected for copying:
City Grading Documents

The second packet was received from PPH in response to a request made on October 5, 2007 to:
1. Inspect: Request(s) for bid (or proposal) regarding the grading/compaction, and/or re-compaction of PPH's ERTC site.
2. Inspect" Bids (or proposals) responsive to request(s) of item 1.
3. Inspect: documents, records, and/or correspondence, related to geotechnical analysis of the PPH's ERTC [site] including soil compaction tests, grading fill analysis, core samples, soils reports, subsoil reports, and the like.
4. Inspect: correspondence with OSHPD, City of Escondido, or JRM-ERTC regarding the suitability of placing a new hospital on PPH's ERTC site.

PPH produced a stack of documents about 8 inches high. After selecting about 110 documents for copying on October 16, 2007, these documents were provided the same day.
PPH Grading Bid Award (4/13/07)
PPH Grading Winning Bid (Pinnick - 4/10/07)
This second set of documents was provided on November 2, 2007:
PPH Grading Documents II
After complaints about missing documents, this third set of documents was provided on November 5, 2007:
PHH Grading Documents III

More documents should be coming! PPH provided a copy of a letter from the City of Escondido to JRM. This letter was not in the documents provided by the City. Wally has asked the City to provide documents between the City and JRM about the grading issues. Also, PPH did not provide any documents to or from OSHPD about the grading issues. Wally has requests those documents from PPH.

McLeod Tower "likely to be reclassified"!

2007-11-15T09:40:00.000-08:00

Newsflash!

"Palomar Pomerado is preparing to break ground on a new hospital that was sold to the public as being more economical than trying to upgrade two Palomar Medical Center towers rated as extremely vulnerable to earthquakes. Covert said Wednesday architects have told him the towers also are likely to be reclassified.

Still, he said, "I don't think it will change our time frame in terms of (construction) activity."

See the article at this link:
State to re-assess hospitals' vulnerability to quakes

This means the McLeod tower can remain in operation until 2030. However, PPH is determined to not save the district's taxpayers any money!

PS - Gound has already been broken for the new hospital, as reported in the blog entry of October 15th!

Evolution of PPH Retrofit Costs

2007-11-14T21:25:00.000-08:00

The cost for PPH to retrofit its downtown hospital (PMC) has gone from $93 million to $3 million!

The cost of constructing the scaled down hospital in the ERTC has increased by $83 million to $773 million.

Further PPH must generate additional cash from operations over the next 10 years (an increase to $67.7 million each year) in order to fund the current (scaled-back) expansion plans.

See the details in this handout:
Cost Comparison Handout

ERTC Soil Remediation

2007-11-07T18:49:00.000-08:00

There are big rocks and boulders buried in the ERTC property acquired by PPH for the new hospital. PPH knew about the buried rocks (with accompanying voids), and the estimated remediation costs, BEFORE it acquired the property.

Here is a handout having a selection from documents received based on requests to PPH about the "soil remediation" issue.
Handout 11/07/2007

Exemplary quotes:
"However, for this rock fill material loosely constrained by smaller gravel and fine sands, there is no known method for predicting its seismic performance, ground motion characteristics or stability under ground shaking. We would be hard pressed to place our engineering seal of approval on the report recommending construction of a hospital on these rock fill materials at the ERTC site."

"The most rational option for remediating the grading conditions so the entire site may be used for hospital construction would be to remove and replace the rock fill with fine fill materials using the ground-up boulders in the process. . . . The option of removing, grinding up the rock materials to fine materials and replacing them in a properly compacted process over the site has been estimated at $30 Million."

"We are concerned that some areas of the site may not conform to the City's rock fill placement requirements as shown in Appendix A in the reports. Prior to approval of the final grading for ERTC, and issuance of a grading permit for PPH, we would like to receive clarification on these issues."

New PPH Board Appointment

2007-11-04T09:43:00.000-08:00

The PPH Board has appointed Linda Bailey to fill the position on the Board opened by the resignation of Gary Powers.

"Bailey, who lives just outside Escondido's city limits with her husband, Randy, said she enjoys being active with civic groups."
http://www.signonsandiego.com/news/
northcounty/20071103-9999-1mc3pph.html

PPH ERTC Groundbreaking!?

2007-10-15T19:23:00.000-07:00

PPH has started moving dirt in the ERTC. Strangely, no ground breaking ceremony was announced by PPH.

The City called this phase "soil remediation" in the 9/12/07 City Council meeting. The soil remediation project is going to last several months. City engineer Homi Namdari said that the hospital site is mostly rock (covered with only 5 feet of dirt). The rock needs to be removed for the basements, so blasting will be occurring at the site.

I feel there are more issues involved in the soil remediation than the mere removal of rock.

According to the grading plans on file with the City. Some areas have "undocumented fill" requiring "the contractor to over excavate and recompact existing undocumented fill in accordance with the recommendations of the soils report." Item 12, page 1 of 15, Document #GP07-0027, Department of Public Works, Engineering Division, City of Escondido. "No fill to be placed until the City Grading Inspector has inspected and approved the bottom excavation." Item 13 ". . . Rocks larger than six inches in diameter shall not be used in the fill." Item 16 "The fill shall be compacted to at least 95 percent." Item 17. A soils report, prepared by URS Corporation, was dated January 2007. Item 3, under City of Escondido Grading Notes.

I'm hearing the "soil remediation" will be expensive.

For mention of "soil remediation" by the City staff in the City Council meeting of 09/19/07, see See Video at minute 19:12 of video 9 (Item 14).

PPH purchased the ERTC Property "as is": ERTC Option Contract (Article 7, paragraphs 7.2 and 7.2.1).

I doubt PPH had any soils reports prepared during the 11 months between when the Option Contract was signed, and when the option was exercised. PPH has not mentioned "soil remediation" as a budget item. Some level of grading has always been part of the construction plan.

PPH Board Replacement

2007-10-12T17:20:00.000-07:00

PPH is accepting letters of interest for the vacant Board position. The deadline is Friday, October 19th.

PPH Board Member Resigns

2007-09-15T14:22:00.000-07:00

PPH Board member Gary Powers announced that he will resign from the PPH Board. The PPH Board will meet on Monday, September 17, 2007, 6 pm, at the Pomerado Hospital meeting room.

Gary Powers was appointed by the PPH Board on April 28, 2006, to fill the vacancy left by the resignation of PPH Board member Nancy Scofield.

$2.5 Million For Valley Blvd Relocation

2007-07-29T20:13:00.000-07:00

Escondido estimates that it will cost $2.5 million to relocate Valley Blvd in order for PPH (Palomar Pomerado Health) to build a 50,000 square foot office building as promised in its MOU.

The Project is included in Escondido's Capital Improvement Plan for 2007/2008 on page 46.
http://civics.robroy.cc/CIPBudget2007-2008p46.pdf (page 46)
http://civics.robroy.cc/CIP 2007-08 - 2011-12.pdf (Entire Document 10.5 MBytes)

MOU:

http://civics.robroy.cc/AB.pdf

Keep Hospital Downtown

2007-07-10T15:51:00.000-07:00

An Escondido Doctor wrote the following letter to the editor of the North County Times:

"I have practiced at Palomar Hospital and lived in Escondido for over 30 years and, just like the hospital board members, am amazed at the increased cost of building a whole new hospital in the Auto Park area of our city. This will drive up the cost of health care for all of us who live in the Palomar hospital district. The move will also hurt downtown Escondido since there won't be money left to significantly renovate the present hospital site.

Since much of the present downtown hospital is fairly new and will meet earthquake standards for many years, and since the present site is so convenient for those relying on public transportation and ride sharing, the PPHS board should realize that the original plan to build a new tower at the downtown site is best for the district residents. Abandoning this site and building a whole new hospital is like throwing the baby out with the bath water, and I should know since I practiced obstetrics for over 30 years at Palomar.

District residents should contact the Palomar hospital board by e-mail at tlc@pph.org or call (800) 628-2880 and ask them to keep our hospital downtown.

Dr. Arthur Stehly
Escondido"
http://www.nctimes.com/articles/2007/06/21/
opinion/letters/6_20_0717_06_27.txt

La Jolla VA Hospital Retrofit

2007-06-16T12:57:00.000-07:00

The Veterns Administration (VA) hospital in La Jolla next to UCSD is under going "Earthquake Retrofitting". Massive columns and beams are being added to the hospital building's structure. The hospital is open for business during the retrofit with people going in and out and the parking lots being full.

The seismic corrections on Building No. 1 at the VA Medical Center in San Diego, were funded in
the amount of $47,100,000:
http://www.house.gov/hensarling/rsc/doc/Lb52002.pdf
http://thomas.loc.gov/cgi-bin/bdquery/z?d107:h.r.04514

The $52.2 million contract with Clark Construction of Costa Mesa, California started in November 2005.
http://www.pugetsound.med.va.gov/opa/
pressrel/pressrelease.cfm?id=1040

Building 1 is an 855,000-square-foot, 6-story cruciform structure that was built in 1970. The original design included 8 stair towers along the exterior of the building. These towers serve as structural connections and support for the building. The seismic retrofit design required removal and replacement of the existing structurally deficient stair towers to meet today’s stricter seismic building codes.
http://www.andersondrilling.com/Projects_Detail.aspx?pProjectId=61

Soaring Costs Cause PPH To Cancel Downtown Renovations

2007-05-24T13:25:00.000-07:00

The cost for a new hospital in the ERTC has soared to $811 million, from an original estimate of $531 million in July 2004. To cover the soaring costs, Palomar Pomerado Health is positioned to use the $73 million originally earmarked for renovation of the downtown hospital (Palomar Medical Center), and apply that money to the cost overruns on the new hospital.

Also, PPH cannot afford to build a Women's and Children's center in Escondido, so it is positioned to use the downtown facility beyond the seismic retrofit deadline (initially 2013).

A video of the presentation to the PPH Board at a meeting held on May 22, 2007 is at the following link:
Video File (22MBytes)

OSHPD Progress Reports

2007-04-23T17:57:00.000-07:00

OSHPD has abbreviated hospital project progress reports available online.
OSHPD Proj. Status Search Page

The facility numbers for PPH facilities are below:
Palomar Medical Center West - 18173
Palomar Medical Center (Downtown) - 12347
Pomerado Hospital - 14190

An interesting comments appears for Palomar Medical Center West, Project # IL061126, Sub #: 0, Activity: 230, Pad: FL003, "EXT.TORSIONAL IRREGUILARITY: INITIAL:03/13-03/21/07: CLOSED WON'T RESUBMIT"

PMC West Activity Comment

Not sure what that means!?

PPH New Web Site With Agendas & Minutes

2007-03-21T18:16:00.000-07:00

PPH has begun to post Board meeting agendas and minutes on its new website. This is great news!
http://www.pph.org/about.aspx?nd=139

Of course I would like to see the support materials and committee agendas, but I am quite pleased with this development!

The Prop BB Oversight Committee's meetings are also online.
http://www.pph.org/about.aspx?nd=714

Stay Tuned?! FPPC Fines Prop BB Contributors

2007-01-10T21:32:00.000-08:00

The FPPC is enforcing fines and penalties against certain "Major Donor" contributors to the Yes On Prop BB campaign for not filing the proper reporting forms. The fines are for significant amounts.
http://www.fppc.ca.gov/index.html?id=329

Item 8 http://www.fppc.ca.gov/index.html?id=60
Failure to Timely File Major Donor Campaign Statements. Chief Investigator Sue Straine and Political Reform Consultant Mary Ann Kvasager. The following persons and entities have entered into a stipulation for failing to file major donor campaign statements that were due during calendar year 2004 in violation of Government Code Section 84200:

In the Matter of Palomar Medical Center Medical Staff, FPPC No. 06-0558. Palomar Medical Center Medical Staff of Escondido failed to timely file a semi-annual campaign statement disclosing contributions totaling $50,000 (1 count). Order and Exhibit ($900 fine).

In the Matter of Palomar Medical Center Auxiliary, FPPC No. 06-0564. Palomar Medical Center Auxiliary of Escondido failed to timely file a semi-annual campaign statement disclosing contributions totaling $10,000 (1 count). Order and Exhibit ($400 fine).

In the Matter of Pomerado Medical Staff, FPPC No. 06-0567. Pomerado Medical Staff of Poway failed to timely file a semi-annual campaign statement disclosing contributions totaling $50,000 (1 count). Order and Exhibit ($900 fine).

More details regarding contributors to the Prop BB Campaign and FPPC manuals are available at:
http://civics.robroy.cc/fp.html

New Blog Focusing on Illegal Immigration

2006-12-21T20:27:00.000-08:00

This issue of illegal immigration is much larger than Escondido. It is a issue between nations and cultures, with local effects. Thus, it is also a conflict between the Federal Government, and the state and local governments.

Those matters go beyond the typical civic matters of Escondido followed in this blog. If you want to follow the illegal immigration matter, check the following blog:
http://escocase.blogspot.com/
titled "Local Control & Supremacy "

Example of a Complaint Form

2006-10-23T14:32:00.000-07:00

An example of a Complaint Form that may be effective in making complaints under the new Escondido Ordinance (Municipal Code Section 16E-2a) banning the harboring of illegal aliens is available at the link below. The Complaint Form focuses on landlords having poorly maintained properties, overcrowding, or irregular tenancy arraignments.
http://civics.robroy.cc/HarboringComplaintForm-v02.pdf

On September 30th, a North County Times article had the following quote:
"Complaints, she [Marie Waldron] said, would likely follow from other city code enforcement investigations, such as illegally parked cars and other property violations." Escondido ordinance would ban renting to illegal immigrants

The attached Complaint Form example lists objectively observable conditions related to property maintenance, overcrowding, and lack of normal tenancy arraignments.

The Complaint Form example relies on a well-known link between such objectively observable conditions and illegal alien tenants afraid of complaining for fear of consequences.

Published examples of the well-known link:
"The signs in National City called Mayor Inzunza a slumlord and claimed he supported the [sanctuary] law because he profits from filling his apartments with illegal aliens. They’re not totally wrong on that. An investigative report by the San Diego Union-Tribune found that Inzunza was a terrible landlord and that many of his 100 rental units were of the rat-hole variety. Illegal immigrants fear complaining about poor conditions and often are abused by just such landlords. In National City and Escondido, the advocates for the poorest of the poor are sometimes in league with some of their worst abusers."
http://www.sdcitybeat.com/article.php?id=4910

"Ricciardelli, who said he has been a landlord for 25 years, said that most of his tenants 'would never complain about the bars on the windows or anything like that -- most of them are illegal aliens.' Five of the tenants to whom the [Las Vegas] Sun spoke on Tuesday confirmed that they wouldn't ever make a peep about those problems because they are afraid of consequences ranging from rent increases to deportation."
http://www.lasvegassun.com/sunbin/
stories/sun/2005/feb/11/518277265.html?Andres%20Ramirez

NLRC Study: Mission Park, Escondido, California

2006-10-18T10:54:00.000-07:00

The National Latino Research Center's Mission Park Community Study is available at from the Union Tribune at the following link:
http://www.signonsandiego.com/news/northcounty/
images/061018nlrcreport.pdf

The study's lead researcher and author claims that the study is being misused and that she would not have conducted it for the City of Escondido if she knew that it would be used to justify the rental/harboring ban ordinance. The NLRC was paid $10,000 by the City for the study.
http://www.signonsandiego.com/news/northcounty/
20061018-9999-1mi18mission.html

Students at Cal State San Marcos volunteered to help in the study as data collectors and interviewed Mission Park residents.
http://www.csusm.edu/nlrc/projects/
http://www.csusm.edu/nlrc/publications/Newsletter/
NLRCNewsletter_Fall2005.pdf (page 5).

Quotes from the study:

"With an average federal poverty rate of 29%, the Mission Park area has been identified as having one of the most rapidly growing poverty rates in the State of California," page 14

"Immigration and Citizenship Status
The Mission Park area is home, and often the 'first stop' for many new immigrants seeking better opportunities in the United States. Language is a barrier for many, with 44% speaking English less than “very well”. Although the survey did not collect information about citizenship status, this seems to be key consideration for residents in this community." page 15

"Renters who are new immigrants and/or are exceeding the unit capacity are also less likely to complain or identify maintenance problems that could lead to unhealthy housing (mold, mildew, poor ventilation, lead, roach or rodent infestations, or other potential health hazards)." page 18

"Lack of information & fear: Fear of immigration/border patrol." page 25

"A large majority (85%) of survey participants were born outside of the United States. Most participants (81%) were born in Mexico, while fewer were born in other non-U.S. areas (Central America: 3%, “Other”: 1%)." page 30

"When asked “In what language do you usually communicate?” a majority of respondents (66%) indicated Spanish. A substantial number (18%) indicated that they communicate in both Spanish and English, 16% indicated English, and 0.2% indicated each of Mixteco, French and Swahili, and Tagalog." page 30

"The most frequently cited reasons for lacking health insurance were cost and immigration
status." page 44

Hospital Seismic Retrofit Deadline Extended Two Years

2006-10-08T20:48:00.000-07:00

SB1661 grants a two-year contruction extension for hospitals trying to meet California's strict seismic regulations for acute care hospital space. It appears that PPH can now delay submission to OSHPD of its plans for the new hospital until Jan 1, 2009, and not complete construction until 2015!

SB1661 was signed by the governor on 9/29/06.
http://info.sen.ca.gov/cgi-bin/postquery?bill_number=sb_1661&sess=CUR&house=B&site=sen

Full text of bill:http://info.sen.ca.gov/pub/bill/sen/sb_1651-1700/sb_1661_bill_20060929_chaptered.pdf

History:http://info.sen.ca.gov/pub/bill/sen/sb_1651-1700/sb_1661_bill_20060929_history.html

Senate Analysis: The bill authorizes OSHPD to grant the additional extension if the hospital building subject to the extension meets certain criteria:
http://www.blogger.com/

Escondido Bans Harboring Of Illegal Aliens

2006-10-05T21:41:00.000-07:00

The Escondido City Council voted to ban the harboring of illegal aliens by landlords. The vote was 3-2. One of those voting for the ban is up for reelection.
http://www.nctimes.com/articles/2006/10/05/
news/top_stories/3_00_0010_4_06.txt

My comments to the City Council are included below:

The Supremacy Clause of the US Constitution gives the Federal Government virtual exclusivity in defining legal and illegal immigration. Local Governments must accept those definitions, and not conflict with them, when crafting ordinances.

The US Congress has made harboring of illegal aliens, knowingly or with a reckless disregard for the facts, a criminal felony punishable with fines and up to 5 years imprisonment, or up to 10 years imprisonment if the harboring is “done for the purpose of commercial advantage or private financial gain.” 8 USC § 1324

It is important to understand the meaning of the term harboring. Black’s Law Dictionary (7th Edition) gives the following definition:

Harboring, n. The act of affording lodging, shelter, or refuge to a person, esp. a criminal or illegal alien.

Much has been said about the hardships that this ordinance may have on children, who are U.S. citizens, and who have parents who are illegal aliens. Again, Congress has provided for relief from a removal proceeding (commonly known as deportation) by allowing cancellation of the removal and adjustment of immigration status if the removal would result in a particular level of hardship to the US citizen child and other strict conditions. 8 USC § 1229b(b).

Admittedly, cancellation is not easy to achieve, but the Federal Agencies and Courts deal with cancellation proceedings on a regular basis. It is the Federal Government’s area of expertise. If this Council starts writing exceptions to the federal immigration scheme, it will likely invalidate the ordinance. Congress has set the standard. Further, Congress has required the implementation of a system by which State and Local Governments can efficiently and effectively request verification of immigration status from the Federal Government.

Opponents to this measure are against the express policies of the US Congress. The Supreme Court has upheld local laws affecting illegal aliens that are consistent with congressional objectives on numerous occasions. De Canas; Arizona v. Salazar.

This ordinance is harsh only because those most affected by it have ignored the Federal scheme for immigration. They have decided to live beyond the law. The Federal Government has been overwhelmed by the situation.

Now the illegal aliens are demanding that the US Congress change the law. The US Congress has said no. Instead, the US Congress has decided to build a fence along large segments of the southern border. The US President and the Governor of this State have sent National Guard Units to the southern border to assist in securing it against breach. The congressional objectives have been set. This Council’s objectives have been set forth in this ordinance. I urge you to pass it.

October 4, 2006
Escondido, CA

Proposed Escondido Ordinance For Addressing Illegal Immigrant Overcrowded Housing

2006-09-30T23:28:00.000-07:00

The draft Escondido ordinance is now ready for consideration by the City Council:
http://civics.robroy.cc/Item100406-13a.pdf

The meeting will take place on October 4th at the 7 pm session.

The ordinance makes it illegal for dwelling owners to "harbor" illegal aliens in Escondido. Dwelling owners can lose their business license for violating the prohibition. Further violations can result in fines and harsher penalties.

Definition from Black's Law Dictionary, 7th Edition:

harboring, n. The act of affording lodging, shelter, or refuge to a person, esp. a criminal or illegal alien.

Federal law renders it unlawful to habor illegal aliens, with enhanced penalties if the harboring "was done for the purpose of commercial advantage or private financial gain."
8 U.S.C. 1324(a)(1)(A)

Section 1324. Bringing in and harboring certain aliens
(a) Criminal penalties
(1)(A) Any person who -
. . .
(iii) knowing or in reckless disregard of the fact that an alien has come to, entered, or remains in the United States in violation of law, conceals, harbors, or shields from detection, or attempts to conceal, harbor, or shield from detection, such alien in any place, including any building or any means of transportation;
(iv) encourages or induces an alien to come to, enter, or reside in the United States, knowing or in reckless disregard of the fact that such coming to, entry, or residence is or will be in violation of law; or
(v)(I) engages in any conspiracy to commit any of the preceding acts, or
(II) aids or abets the commission of any of the preceding acts, shall be punished as provided in subparagraph (B).
(B) A person who violates subparagraph (A) shall, for each alien in respect to whom such a violation occurs -
(i) in the case of a violation of subparagraph (A)(i) or (v)(I) or in the case of a violation of subparagraph (A)(ii), (iii), or (iv) in which the offense was done for the purpose of commercial advantage or private financial gain, be fined under title 18, imprisoned not more than 10 years, or both;
(ii) in the case of a violation of subparagraph (A)(ii), (iii), (iv), or (v)(II), be fined under title 18, imprisoned not more than 5 years, or both;
(iii) in the case of a violation of subparagraph (A)(i), (ii), (iii), (iv), or (v) during and in relation to which the person causes serious bodily injury (as defined in section 1365 of title 18) to, or places in jeopardy the life of, any person, be fined under title 18, imprisoned not more than 20 years, or both; and
(iv) in the case of a violation of subparagraph (A)(i), (ii), (iii), (iv), or (v) resulting in the death of any person, be punished by death or imprisoned for any term of years or for life, fined under title 18, or both.

PPH Delay Bond Issuance

2006-09-26T22:03:00.000-07:00

PPH has delayed issuance of its revenue bond offering, orginally scheduled for July and then October, until December 2006. The reasons given were a need to refinance prior bonds, and spend-down requirements for using the bond proceeds.

IRS rules allow limited arbitrage using bond proceeds. A summary is available at:
http://www.prestongates.com/
publications/pubDetail.asp?id=306

PPH claims it will start construction of its new PMC West hospital in the ERTC in January 2008. That is only 13 months after the new projected date of the bonds. Since PPH is delaying the revenue bond offering, one can speculate that the new hospital start date has slipped at least 5 months.

Bibray Tiptoes Around Illegal Immigrant Rental Issue

2006-08-28T21:56:00.000-07:00

A recent letter to Congressman Bilbray asked:
http://civics.robroy.cc/BilbrayLtr071406.pdf

"The Escondido City Council has proposed a measure that would fine landlords for renting to illegal immigrants. (Newspaper articles about the measure are attached)

Do you support the proposed Waldron measure?

Some claim that the Waldron measure would violate existing state and Federal laws, such as fair housing laws.

Would you support or sponsor Federal legislation that would allow local measures, such as the proposed Waldron measure, without running afoul of any Federal or state laws?

Some have claimed that this is solely a Federal matter.

Would you support or sponsor Federal legislation making it illegal to rent to illegal immigrants?"

The congressman's response tiptoed around the issue. See
http://civics.robroy.cc/BilbrayResponseLtr080806.pdf

PPH Revenue Bonds

2006-08-15T10:04:00.000-07:00

PPH is planning on raising $150 million this fall using revenue bonds.

Some issues have arisen with the bond offering. Apparently, previous revenue bonds issued in 1993 and 1999 "may prevent PPH from issuing both Revenue and GO bonds if certain financial targets are not met."

(pages 57-65 in the meeting packet below.)
The entire meeting packet is at:
http://civics.robroy.cc/PPHBdSupport081406.pdf (7.7 MBytes)

California Housing Law - Citizenship Checks Not Listed As Discrimination

2006-07-23T12:09:00.000-07:00

According to an article by the San Francisco Apartment Association, illegal aliens are not protected class under California Housing Law. The article has some brief comments about the differences between the Federal law and California law.
http://www.sfaa.org/magazine/archives/06/apr/0604.snitow.html

California law has an additional prohibition against discrimination based on "ancestry". In California, it should not matter who are your parents or grandparents. The article gives the example of Osama Bin Laden's granddaughter. She cannot be denied housing based on that fact.

Otherwise, the California law seems similar to the US law:
Govt. Code
12921. (a) The opportunity to seek, obtain and hold employment
without discrimination because of race, religious creed, color,
national origin, ancestry, physical disability, mental disability,
medical condition, marital status, sex, age, or sexual orientation is
hereby recognized as and declared to be a civil right.
(b) The opportunity to seek, obtain, and hold housing without
discrimination because of race, color, religion, sex, sexual
orientation, marital status, national origin, ancestry, familial
status, disability, or any other basis prohibited by Section 51 of
the Civil Code is hereby recognized as and declared to be a civil
right.
Govt Code
12955. It shall be unlawful:
(a) For the owner of any housing accommodation to discriminate
against or harass any person because of the race, color, religion,
sex, sexual orientation, marital status, national origin, ancestry,
familial status, source of income, or disability of that person.

http://www.leginfo.ca.gov/calaw.html

Although California law has more prohibitions, discrimination based on citizenship is not one of the added prohibitions. Also, note that the employment provision has similar discrimination prohibitions.

Some have asserted that discrimination based on Citizenship is covered by the Unruh Civil Rights Action Section 51 (CA Civil Code 51).

I reproduce that section here:
51. (a) This section shall be known, and may be cited, as the Unruh
Civil Rights Act.
(b) All persons within the jurisdiction of this state are free and
equal, and no matter what their sex, race, color, religion,
ancestry, national origin, disability, medical condition, marital
status, or sexual orientation are entitled to the full and equal
accommodations, advantages, facilities, privileges, or services in
all business establishments of every kind whatsoever.

Again, the prohibition is for discrimination based on ancestry and national origin. No mention of discrimination based on citizenship.

In conclusion, California law is more stringent, but citizenship is not a prohibited class.

HUD - Citizenship Check NOT Federal Housing Discrimination

2006-07-20T11:56:00.000-07:00

The US Department of Housing and Urban Development has stated that screening housing applicants on the basis citizenship status does not violate the Fair Housing Act (42 USC 3601+).

Below I have copied the relevant text from the HUD web site:

http://www.hud.gov/offices/fheo/
library/sept11.cfm

U.S. Department of Housing and Urban Development
Fair Housing and Equal Opportunity

Response to concerns about housing security following September 11, 2001

Rights and Responsibilities of Landlords and Residents in Preventing Housing Discrimination Based on Race, Religion, or National Origin in the Wake of the Events of September 11, 2001

In response to the widespread concern of future terrorist attacks, landlords and property managers throughout the country have been developing new security procedures to protect their buildings and residents. Many have educated their residents on the signs of possible terrorist activity and how to communicate security concerns to management or law enforcement. Landlords and property managers are working to keep their buildings safe, but at the same time they are responsible for making sure their efforts do not infringe on the fair housing rights of current or potential residents. Since the attacks of September 11, 2001, persons who are, or are perceived to be, Muslim or of Middle Eastern or South Asian descent have reported increased discrimination and harassment, sometimes in connection with their housing. To help address this growing concern, the following is a review of federal fair housing laws and answers to some questions regarding housing discrimination that have been raised since the events of September 11, 2001.

The Fair Housing Act
The Fair Housing Act (the Act) prohibits discrimination because of race, color, religion, sex, national origin, disability, and familial status in most housing related transactions. Further, the Act makes it unlawful to indicate any preference or limitation on these bases when advertising the sale or rental of a dwelling. The Act also prohibits harassment of anyone exercising a fair housing right and retaliation against an individual because s/he has assisted, or participated in any manner, in a fair housing investigation.

Screening and Rental Procedures
It is unlawful to screen housing applicants on the basis of race, color, religion, sex, national origin, disability, or familial status. In the wake of the attacks of September 11, 2001, landlords and property managers have inquired about the legality of screening housing applicants on the basis of their citizenship status. The Act does not prohibit discrimination based solely on a person's citizenship status. Accordingly, asking housing applicants to provide documentation of their citizenship or immigration status during the screening process would not violate the Fair Housing Act. In fact, such measures have been in place for a number of years in screening applicants for federally-assisted housing. For these properties, HUD regulations define what kind of documents are considered acceptable evidence of citizenship or eligible immigration status and outline the process for collecting and verifying such documents.* These procedures are uniformly applied to every applicant. Landlords who are considering implementing similar measures must make sure they are carried out in a nondiscriminatory fashion.

Example 1: A person from the Middle East who is in the United States applies for an apartment. Because the person is from the Middle East, the landlord requires the person to provide additional information and forms of identification, and refuses to rent the apartment to him. Later, a person from Europe who is in the United States applies for an apartment at the same complex. Because the person is from Europe, the landlord does not have him complete additional paperwork, does not verify the information on the application, and rents the apartment. This is disparate treatment on the basis of national origin.
Example 2: A person who is applying for an apartment mentions in the interview that he left his native country to come study in the United States. The landlord, concerned that the student's visa may expire during tenancy, asks the student for documentation to determine how long he is legally allowed to be in the United States. If the landlord requests this information, regardless of the applicant's race or specific national origin, the landlord has not violated the Fair Housing Act.
*See HUD Regulations at 24 CFR 5.506-5.512

Crime Maps In San Diego County

2006-07-19T19:41:00.000-07:00

A new Internet-based crime mapping system is now available to the public for San Diego County. The site will generate maps of crimes around schools, hospitals, addresses, and the like. The incident icons on the map, when clicked, show the time and type of crime.

The site has been very popular since it was announced a few days ago. The maps can be accessed from links on the following web site:
http://www.arjis.org/

I searched for crimes in Escondido. The maps indicate that most crimes in Escondido occur in the central region bounded by I-15 on the west, Ash on the East, El Norte Parkway on the North, and 9th on the south. The further one gets from this region, the fewer reported crimes.

Waldron Proposal Would Prohibit Rentals To Illegal Aliens

2006-07-14T17:46:00.000-07:00

Escondido Councilwoman Marie Waldron is proposing that the City prohibit renting to illegal aliens. Apparently, the proposal was inspired by an ordinance being considered in Hazleton, Pennsylvania.

What is interesting is how the matter was reported in the local press. The North County Times ran an article on Sunday, July 9, 2006:
http://www.nctimes.com/articles/2006/07/09/
news/inland/21_03_117_8_06.txt
The NCTimes allows reader comments to be posted on its web site under an article. This article drew over 150 comments!

The NCTimes Editor wrote an Opinion piece that blasted the Waldron proposal:
http://www.nctimes.com/articles/2006/07/11/
opinion/editorials/22_01_387_10_06.txt
The Opinion drew over 70 comments!

The NCTimes then ran an article about Latinos organizing to oppose the Waldron proposal.
http://www.nctimes.com/articles/2006/07/13/
news/inland/21_43_407_12_06.txt
That article drew over 90 comments!

The Union Tribune ran an article after the NCTimes:
http://www.signonsandiego.com/news/
northcounty/20060712-9999-1mi12illegal.html
The UT had a survey next to the article. I took the survey, and was presented with the result. 85% responding to the survey were in favor of the Waldron proposal.

Then, a story about Latino oponents who addressed the City Council was reported:
http://www.signonsandiego.com/news/
northcounty/20060713-9999-1m13illegal.html

Then a UT columnist criticized the Waldron proposal:
http://www.signonsandiego.com/news/
northcounty/jenkins/20060713-9999-1mi13jenkins.html

Constrast that reporting with The Paper.
http://thecommunitypaper.com/localnews.php
The Paper had quotes from several members of the Escondido City Council. Part of the article is quoted below:
"Councilman Ron Newman is not “real warm,” to Waldron’s idea. “I sometimes wonder, with an election right around the corner if proposals such as this, which are very popular with the community, but possibly not do-able legally, are more for show. I don’t think her idea will stand up to a legal challenge. I have a good relationship with Marie . . . but I’m mindful that she’s running for re-election in November . . . I would need more input.”
“Both issues, renting to illegals and restricting the number of tenants in a single family residence, become property rights issues.”
Pointed out that housing agencies that provide governmentally subsidized housing do, indeed, require proof of citizenship . . . but that private ownership did not . . . Newman agreed that there appeared to be a double standard. “I know we place certain restrictions on Habitat for Humanity homes we build in partnership with the community, and to some extent, subsidize . . . but whether we could do that with private ownership I just don’t know. We’d need some legal counsel.”

(Note: Newman has announced that he will not run for a second term in the fall)

The Paper included a Commentary titled: How Eisenhower solved illegal border crossings from Mexico
http://thecommunitypaper.com/editorial.php

What did I learn from The Paper that I did not learn from the other papers. First, that the ordinance has not been drafted yet. Further, that Marie Waldron "is presently doing research to determine how such an ordinance might be written to comply with existing fair housing laws." Thus, arguments that the ordinance violates fair housing laws are premature. Second, citizenship is required for government subsidized housing. This includes housing in Escondido by Habitat for Humanity. Third, that Newman had an opinion, and needed legal guidance. Fourth, that President Eisenhower had to address the same problem of an illegal immigration crisis. Good job at The Paper.

The Community Paper was well worth the price. It was free. Best of all, it had an example of good journalism!

Escondido's Meeting Support Materials Now Available On The Web

2006-06-30T17:33:00.000-07:00

As promised a few months ago, the City of Escondido now has its meeting support materials available on the web.
This is great news!
Previously, these support material were only available at the City Clerk's office during during business week days, or at the Library. Sometimes the Library copy was delayed in the 'inter-office mail', and the copiers at the Library do not have an automatic sheet feeder.
The materials may be accessed using the following link:
http://www.ci.escondido.ca.us/government/
agendas/PublishedMeetings.htm

PPH Finally Pays $13 Million Into Citracado Trust Fund

2006-06-18T21:28:00.000-07:00

PPH has finally paid the $13 million into the Citracado Trust Fund. The money was initially due on March 24, 2006. Now the City of Escondido should get on with constructing the road extension!

PPH Fails To Set Up $13 Million Citracado Extension Trust Fund

2006-05-30T19:19:00.000-07:00

PPH promised to fund the extension of Citracado Parkway from the ERTC to Valley Parkway. PPH was supposed to set up and fund a trust account for the amount of $13 million by March 24, 2006. The City of Escondido is the beneficiary of the account for work performed to complete the Citracado Parkway extension.

The community was made aware of PPH's failure to fund the trust account by Dr. Michels:
http://www.nctimes.com/articles/2006/04/20/
opinion/letters/4_19_0617_45_47.txt
and comment to City Council (item #6 - Oral Communications):
http://escondido.12milesout.com/Escondido/
EventList.aspx?id=114

I made a public records request and received a few emails between the City and PPH about who would be on the account. When I went to the City Council meeting two weeks later, the $13 million payment from PPH was not in the trust account. (item #1 - Oral Communications):
http://escondido.12milesout.com/Escondido/
EventList.aspx?id=117

Information received through informal channels said that the money would be place in the trust account on June 1.

Measure To Fine Landlords For Renting To Illegal Immigrants

2006-05-05T09:02:00.000-07:00

An article about a Ballot Measure in the City of San Bernardino was on page A-3 of the NCTimes, but I cannot find a link to it. NC Times quote: "Turner said the initiative specifically aimed to circumvent a Supreme Court ruling prohibiting public schools from asking student for proof of legal residency. 'If an undocumented family can't live in the city, they can't send their children to public schools,' he said."

A more complete article is on the San Bernardino Sun's website:
http://www.sbsun.com/ci_3786656

The measure would:
Ban the use of tax dollars to set up day-labor centers for illegal immigrants.
Impose fines of at least $1,000 against anyone operating a day-labor center without the right permit.
Impose $1,000 fines on landlords who rent to illegal immigrants.
Require city business to be conducted in English, except when federal, state or county law mandates otherwise.
Allow police to seize the vehicles of people who use them to hire day laborers.We know that employer sanctions do not work.

The Tip Of The Iceberg?: Violence Mars Immigrant Protest In Escondido

2006-05-03T07:59:00.000-07:00

In 'peaceful' Escondido, there was a stabbing, there was rock throwing at police, and there were attempts to block streets and the freeway. No arrests! Print headline: 'Latinos Pleased With Boycott"! Maybe the NCTimes and reporter Sifuentes did not expect anyone to read the whole article. What happened Monday was not a 'largely peaceful' protest. Protest leaders should be held accountable for the violence they are instigating!

Online headline: Local Latinos pleased with protest participation
"The Escondido demonstration was generally peaceful, said Lt. David Mankin, spokesman for the Escondido Police Department. But as it was ending Monday night at the park, someone was stabbed and people threw rocks at officers.
. . .
He said 250 to 300 young people, teens or people in their early 20s, marched from Washington Avenue to Lincoln Street and from Broadway to Ash. Sometimes they walked in traffic, forcing drivers to swerve, the lieutenant said."They tried to walk onto the freeway, Highway 78," Mankin said. "Officers were able to divert them back onto Broadway."At one point, the marchers blocked the intersection at Broadway and Washington, but officers were able to clear them away. "
http://www.nctimes.com/articles/2006/05/03/
news/top_stories/15_37_155_2_06.txt

A Day Without An Immigrant Boycott In Escondido

2006-05-01T14:52:00.000-07:00

All week I have been making a note of things to buy today, May 1, 2006.

This morning I woke up and had breakfast. I caught a segment of the morning news. Officer Contreras said that traffic conditions were great--better than normal!

I worked through the morning and had my sandwich for lunch. Time to go downtown by the bank on Grand Avenue wearing my American Flag t-shirt. No indication of any boycott. I did my business and headed up Escondido Avenue to get gas. An SUV had two American flags and one mexican flag waving out the window. It seemed to be circling the civic center block.

After waiting in line, I was able to gas up at the lowest priced gas station in Escondido.

Now to get oil for my pickup. The local auto parts store had a sale on my favorite brand. Bingo! As normal, the shoppers were a mix of Spanish and English speaking customers.

The El Tigre Market was closed as previously announced. That is probably costing El Tigre Market a bundle.

As I headed up Washington to Broadway, I saw two mexican young men carrying rolled up American flags. They did not look too energetic about a cause.

On Broadway, I passed by Grape Day Park at 2 pm. A rather small crowd had assembled by a large mexican flag and a host of smaller American flags toward the northeast corner of the park. I took a picture of the small crowd.

The final leg of my excursion headed east to a drug store at the corner of Valley Parkway and Rose for a list of assorted items. I was third in line at the checkout. As normal!

My conclusion is that this was a day without an effective immigrant boycott in Escondido

PPH Selects Gary Powers For Board Replacement

2006-04-28T14:59:00.000-07:00

The Board of Palomar Pomerado Health (PPH) has selected Gary Powers to fill the recently opened seat on the Board.

Gary Powers is the president and chief executive officer of the San Diego North Chamber of Commerce. The San Diego North Chamber of Commerce formed in 2005 from a merger of the Rancho Bernardo and the Diamond Gateway chambers.
http://www.sdncc.com/

The San Diego North chamber now has more than 1,000 members, including some in Rancho Bernardo, 4S Ranch, Carmel Mountain Ranch, Rancho Penasquitos, and Sabre Springs. Torrey Highlands, Scripps Ranch, Mira Mesa, the Miramar area, and Sorrento Mesa are also among the communities whose businesses are represented by the giant chamber.

It is interesting to note the Mr. Powers had a very good interview before the PPH Board. Also, he had attended only two Board meeting before the interview.

PPH Board Vacancy To Be Filled

2006-04-05T13:25:00.000-07:00

Palomar Pomerado Health has announced that it has a vacancy on its Board of Directors. Nancy Scofield is resigning from the Board. Interested candidates should submit a letter of interest and a resume including experience and background to PPH. The deadline is Monday, April 24, 2006, at 5 pm. Contact PPH for more details.

My observation is that the current PPH Board has little experience related to the giant construction projects that it hopes to undertake. It appears that the current Board will select the person that will fill the existing vacancy. Hopefully, the current Board looks past traditional criteria relating to medical experience and uses this opening to add some expertise that is currently lacking on the Board.

Also, the current Board needs more respresentation from Escondido.

Supervisor Horn & California Sunshine

2006-04-04T19:02:00.000-07:00

Another area politician is having problems complying with California's campaign disclosure laws and regulations. Supervisor Horn has described the disclosure rules as very complicated. Others have stated that the disclosure rules are quite simple.

Most troubling is the difficultly encountered in trying to get an investigation made by the appropriate government official when irregularities are discovered. The local authorities point to Sacramento. Sacramento seems to see San Diego as a foreign land beyond its jurisdiction. The County District Attorney fails to even acknowledge complaints when made.

Recently, San Marcos City Councilman Mike Preston wrote about the lack of action by the California Fair Political Practices Commission, the district attorney and the city attorney in responding to complaints. In addition, he noted that the person making a complaint often must go public is to get an investigation on track. That person is then subject to political attack.
http://www.nctimes.com/articles/2006/02/10/
opinion/commentary/20_05_142_9_06.txt

A better system is needed. The current patchwork of commissions and government agencies not getting the job done! The following article is of interest:

Horn must come clean
By: North County Times Editorial Staff
http://www.nctimes.com/articles/2006/04/05/
opinion/editorials/440661214.txt

National Sunshine Week 2006 - March 12-18

2006-03-08T21:17:00.000-08:00

March 12-18 has be heralded as "National Sunshine Week" by journalism groups, media companies, state press associations, open-government and First Amendment advocates, librarians, civic groups, and educators. More information is available at:
http://www.sunshineweek.org/sunshineweek/about

A cornerstone of California's sunshine laws is the Brown Act (CA Government Code 54950-54963). The first section of the Brown Act reads:

"In enacting this chapter, the Legislature finds and declares that the public commissions, boards and councils and the other public agencies in this State exist to aid in the conduct of the people's business. It is the intent of the law that their actions be taken openly and that their deliberations be conducted openly.
The people of this State do not yield their sovereignty to the agencies which serve them. The people, in delegating authority, do not give their public servants the right to decide what is good for the people to know and what is not good for them to know. The people insist on remaining informed so that they may retain control over the instruments they have created."
http://www.leginfo.ca.gov/cgi-bin/displaycode?section=gov&group=54001-55000&file=54950-54963

Another cornerstone of California's sunshine law is the Public Records Act (CA Government Code 6250-6270).
The first section of the Pulic Records Act reads:

"In enacting this chapter, the Legislature, mindful of the right of individuals to privacy, finds and declares that access to information concerning the conduct of the people's business is a fundamental and necessary right of every person in this state."
http://www.leginfo.ca.gov/cgi-bin/displaycode?section=gov&group=06001-07000&file=6250-6270

The Political Season Begins Early For PPH & Escondido?

2006-02-26T19:33:00.000-08:00

The reader comments added to the following NC Times article on PPH's ERTC decision are quite interesting and political. This years elections, particularly for the PPH Board, may be much more colorful than past elections!
http://www.nctimes.com/articles/2006/02/24/
news/inland/21_40_082_23_06.txt

Mike wrote on February 24, 2006 7:07 AM: "All good things comes to he who waits. This will have a significant impact on raising the quality of life in this area. All voters should not forget next election the three Escondido council members who caused delays and obstructed the hospital for more than a year for petty politics."

Sam wrote on February 24, 2006 2:19 PM: "Mike, Remember that the 3 council members have allowed PPH to build the hospital in Escondido. They should be thanked for their decision. The city did not delay the process 1 day. It took PPH 1 year to fullfil their promise to committ to build Citracado and upgrade Palomar downtown. Since BB passed, PPH has been doing environmental studies and negotiating purshase of land. They still need 18 more months to get the state approval. Stop your Propaganda about the city of Escondido and the council and be appreciative of the happy ending. The final agreement is good for the hospital district and the the city of Escondido. The Council will be remembered for their courage to protect the city's interest."

Disgusted wrote on February 24, 2006 2:46 PM: "Don't count your chickens, Mike. I'm still patiently waiting and closely watching. I agree that this will have a significant impact on the quality of life in this area, while we're paying through the nose for healthcare and taxes. All voters should not forget any future elections and the five Escondido council members who proved to us who really runs this city. I heartily thank you for making this so abundantly clear to the few of us who are actually paying attention. How sad and embarrassing for all of them. See you at the polls!"

The Order wrote on February 24, 2006 8:20 PM: "Up for grabs in this fall's election: 4 PPH board seats, the mayor's seat, and 2 city council seats. The seats at PPH are now held by Krider, Kleiter, Scofield and Larson. (Kleiter was the low voter get in 2002.) The city council seats are now held by Newman and Waldron. Disgusted will need to wait until 2008 to get at Rivera, Bassett and Greer at PPH, and Abed and Gallo at the city. We hear that J.K. wants a seat on the PPH board, T.D'A. wants the mayor's seat, and K.M. wants a seat on the city council."

Foil The Future ERTC-PPH Health Care Monopoly

2006-02-25T18:05:00.000-08:00

A Key To PPH's ERTC Site: PPH's Ability To Control The Land Surrounding The New Hospital

2006-02-24T22:47:00.000-08:00

PPH has decided to exercise the option to acquire the ERTC property. The details of the shadowy Development Agreement between PPH and JRM-ERTC I are now available. Under the agreement, JRM must insert "use restrictions" in the grant deeds of the ERTC property not owned by PPH. The use restrictions requirements are in Section 8.5.2 of:
http://civics.robroy.cc/AC.pdf (JRM Agreement)

Now PPH has control over the use of all of the ERTC properties. PPH can control the property costs of competitive medical services near the new resort-style hospital. The other available properties in Escondido did not provide PPH with this control of the surrounding land. Now it is evident why the downtown location is so unacceptable to PPH. The downtown location failed to allow PPH the control it covets over the land surrounding the hospital.

A comment by a "Local MD" captures the problematic issues surrounding PPH's acquisition of the ERTC property:
Local MD wrote on February 24, 2006 7:54 PM: "So now PPH will control all aspects of the health care delivery system in North County...the real estate, the hospital beds, and the anciliary services. Physicians will be arm-twisted into leasing space from the hospital and to use their services. Has anyone from the PPH Board even mentioned the cost to the patient? Twenty years from now when our insurance premiums, co-pays and deductibles are through the roof we'll curse the fact that we created a monopoly with our own money. This PPH monopoly will have zero incentive to lower prices or improve services because they'll be the only game in town. That said, it will be a majestic structure...just like a Las Vegas casino, ready to pick our pockets."
The reader comment was added to the following NC Times article on the PPH ERTC decision:
http://www.nctimes.com/articles/2006/02/24/
news/inland/21_40_082_23_06.txt

Other reader comments added to the article are quite interesting. Mike, Sam, Disgusted, and The Order had some insightful political comments that will be investigated in a later blog post.

PPH Board Meeting Packet for Feb 23

2006-02-21T22:06:00.000-08:00

The PPH Board Meeting Packet for the February 23, 2006 meeting is available at:
http://civics.robroy.cc/AgendaSummary.pdf Agenda & Summary
http://civics.robroy.cc/AA.pdf Addendum A (ERTC Devel Agmt)
http://civics.robroy.cc/AB.pdf Addendum B (MOU)
http://civics.robroy.cc/AC.pdf Addendum C (JRM Agreement)
http://civics.robroy.cc/AD.pdf Addendum D (ERTC CCR's)
http://civics.robroy.cc/AE.pdf Addendum E (SDG&E Agreement)
http://civics.robroy.cc/AF.pdf Addendum F (ERTC option close)
http://civics.robroy.cc/AG.pdf Addendum G (PDP Agmt)
http://civics.robroy.cc/AH.pdf Addendum H (Services Agmt)
http://civics.robroy.cc/AI.pdf Addendum I (Hospitalist Agmt)
http://civics.robroy.cc/AJ.pdf Addendum J (Jan. Fin. Report)

Take a look at sections 1.1 and 1.2 of the SDG&E Agreement (Addendum E). Now that is some Indemnification and Hold Harmless protection! Compare that with sections 3.6 and 3.7 of the ERTC Development Agreement with Escondido (Addendum A).

In Addendum C, a 50%/50% jointly owned PPH/JRM LLC gets to construct 300,000 square feet of medical office buildings (MOB) in two phases. Recall that the EIR Addendum showed 160,000 square feet of MOB which was projected to generate almost 50% of the traffic from ERTC Planning Area 4. Also, it appears that JRM can walk if the MOB projects are not feasible based on a financial calculation. The PPH/JRM Agreement also appears to lock other medical providers out the remaining land of the ERTC that is not owned by PPH.

No Significant Environmental Impacts?

2006-02-19T21:01:00.000-08:00

Ordinance No. 2006-09
"The City Council of the City of Escondido, California, DOES HEREBY ORDAIN as follows:
. . .
"SECTION 2. That the City Council has reviewed and considered the Addendum to the Final Environmental Impact Report for the Escondido Research and Technology Center (City Log No. ER-2001-12) and Mitigation Monitoring Report prepared for this project and has determined that all environmental issues associated with the project have been addressed and no significant environmental impacts will result from approving this project."

Has the City Council really reviewed the ERTC EIR Addendum? I quote from the ERTC EIR Addendum, Attachment 4, pages 7-8:

"3.2 Emergency Helicopter Operations Noise Impact
. . .
The maximum instantaneous noise levels would range from approximately 80 to 90 dB at the closest residences located west and northwest of the site. This maximum instantaneous noise level range is similar to a heavy truck at a distance of 50 feet. The maximum instantaneous noise level contours associated with helicopter landings or takeoffs are shown in Figure 5. The maximum instantaneous noise level inside the closest homes would vary depending if the windows are open or closed. If the windows are open, it is anticipated that th maximum sound level inside the closest homes could reach 75 dB. If the windows are closed, the maximum sound level could reach 70 dB. These noise levels could result in sleep disturbance for some of the occupants. Based on the recent helicopter records described in the previous paragraph, approximately four to five nighttime flights per month would be anticipated."
http://www.ci.escondido.ca.us/depts/cd/
planning/ertc/addendum.pdf

Is being subjected to sleep disturbances several times a month signficant?

The Escondido City Council has declared the following:
Escondido Municipal Code
"Sec. 17-226. General provisions.
(a) The city council of the City of Escondido finds and declares that:
(1) Inadequately controlled noise presents a growing danger to the health and welfare of the residents of the City of Escondido;
(2) The making and creating of disturbing, excessive, offensive or unusually loud noises within the jurisdictional limits of the City of Escondido is a condition which has persisted and the level and frequency of occurrence of such noises continue to increase;
(3) The making, creation or continuance of such excessive noises which are prolonged or unusual in their time, place and use effect and are a detriment to the public health, comfort, convenience, safety, welfare and prosperity of the residents of the City of Escondido;
(4) Every person is entitled to an environment in which the noise is not detrimental to his or her life, health and enjoyment of property; and
(5) The necessity in the public interest for the provisions and prohibitions hereinafter contained and enacted is declared to be a matter of legislative determination and public policy and it is further declared that the provisions and prohibitions hereinafter contained and enacted are in the pursuance of and for the purpose of securing and promoting the public health, comfort, convenience, safety, welfare, prosperity, peace and quiet of the City of Escondido and its inhabitants.
. . .
This decibel (dB) table compares some common sounds and shows how they rank in potential harm to hearing. Note that 70 dB is the point at which noise begins to harm hearing, that 60 dB is the threshold of stress response, and 45 dB disturbs sleep. To the ear, each 10 dB seems twice as loud."
http://ordlink.com/codes/escondid/
_DATA/TITLE17/
ARTICLE_12__NOISE_ABATEMENT_AND_CO/
Sec__17_226__General_provision.html

PPH Special Meeting For ERTC Approval - Feb. 23

2006-02-17T23:12:00.000-08:00

[Agenda Abstract]
THURSDAY, FEBRUARY 23, 2006, 6:00 MEETING
PALOMAR MEDICAL CENTER
555 East Valley Parkway
Escondido, CA
Graybill Auditorium

PPH JOINT BOARD OF DIRECTORS AND FINANCE COMMITTEE MEETING
(SPECIAL BOARD MEETING AND REGULAR FINANCE COMMITTEE MEETING)
AGENDA POSTING ONLY
Detailed packet to be distributed Tuesday, February 21, 2006

CALL TO ORDER
- Public Comments
--ADJOURNMENT TO CLOSED SESSION
-pursuant to California Government Code §54956.8
Property: ERTC parcels 27-29 & 33-36
Agency Negotiator: Robert Hemker, CFO, PPH
Negotiating Parties: James McCann and Robert Hemker
Under Negotiation: Instruction to Negotiator regarding price, terms and conditions
Estimated date of public disclosure: February 2006
--ADJOURNMENT TO OPEN SESSION

-Action resulting from Closed Session, If Any
- Information Item(s)

1. Approval: Development Agreement Between PPH and the City of Escondido (Addendum A)
2. Approval: Memorandum of Understanding Between PPH and the City of Escondido Concerning the Preservation of Downtown Escondido and the Redevelopment of the Palomar Medical Center (Addendum B)
3. Approval: Development Agreement Between PPH and JRM-ERTC I, LLP (Addendum C)
4. Approval: Agreement as to the Form and Content of the CCR’s Governing the ERTC and the Association (Addendum D)
5. Approval: Ratification of SDG&E Indemnity Agreement for ERTC Properties (Addendum E)
6. Approval: Exercise of Purchase Option Agreement for ERTC Properties (Addendum F)
7. Approval: Operating Agreement with PDP Pomerado, LLC, a California Limited Liability Company (Addendum G)

- ADJOURNMENT TO FINANCE COMMITTEE MEETING

FINANCE COMMITTEE MEETING AGENDA

CALL TO ORDER

1. Review: Health Development Status Report
2. Approval: Administrative Services Agreements - POM (Addendum H)
Paul E. Tomembe, M.D. - Chief of Staff
Benjamin Kanter, M.D. - Chief of Staff Elect
Roger J. Achestal, M.D. - Chair, Quality Management Committee
3. Review: Hospitalist Programs at Palomar Medical Center and Pomerado Hospital (Addendum I)
4. Approval: January 2006 & YTD Financial Report (Addendum J)

- FINAL ADJOURNMENT

Will PPH Unite With Me To Save The Heart Of Downtown Escondido?

2006-02-14T08:59:00.000-08:00

Last night , PPH called on community unity. I hope that PPH soon joins me in my efforts to Save The Heart Of Downtown Escondido, Palomar Medical Center, as a full-service hospital for the community.

Here is a summary of my comments made at the PPH board meeting last night::

1. Under the ERTC Development Agreement, the City of Escondido "shall diligently seek reimbursement from other developers who stand to benefit from the completion of the Citracado Parkway Improvements." I asked for clarification on that City obligation. Was the City obligated to seek reimbursement from developers in the west downtown area or as far away as Via Rancho Parkway?
2. I requested that the Valley Boulevard "crossover" be maintained or realigned no further west than the five "West Properties". I further argued against the total elimination of the crossover.
3. The "hold harmless" clause states that the clause "shall not apply to the extent such damage, liability, or claim is proximately caused by the intentional or negligent act or acts of the City", and the clause appears silent on the City's liability for acts by PPH or other parties.
4. My public records act request for the "Kaiser Agreement" was denied because it contained "trade secrets." PPH has discussed many parts of the Kaiser Agreement in public and those portions are not trade secrets. I requested that PPH redact any remaining trade secrets and make the agreement available for inspection and copy.
5. I noted that PPH is on the horns of a dilemma. I believe that Palomar Medical Center is a fine hospital with the newest emergency room in the area and that it should be saved as an acute care hospital. The emergency rooms at Fallbrook, Tri-City and Pomerado hospitals are all decades older. PPH keeps telling the public that PMC is an old and overcrowded facility. Yet, PMC is PPH's main source of revenue. PPH will continue to lose market share if it keeps making disparaging remarks about PMC. It must face this dilemma over the next 5 or 6 years. If PPH begins making positive and glowing remarks about PMC, they will be assisting me in my effort to "Save The Heart Of Downtown Escondido" as a full-service acute care hospital.

PPH Board Chair Dr. Rivera was so offended by my comments that he tried to cut me off before the allotted time, he told me I was wasting time, and he had his gavel at the ready a minute before the time limit. I ended my comments 30 seconds early.

Legal Liability Of The City Of Escondido - ERTC Hospital Location

2006-02-13T07:58:00.000-08:00

I have reviewed these five documents:
1. ERTC EIR Addendum; 2. ERTC Specific Plan Amendment; 3. Finding of Fact and Statement of Overriding Considerations for the ERTC Specific Plan; 4. ERTC Development Agreement; 5. MOU

The MOU had some language regarding PPH's general liability insurance for the downtown PMC in section XVI (page 14), and Third Party Litigation in section XXIV (page 17). Nothing there appear to release the City of Liability.

The ERTC Development Agreement has several paragraphs relating to litigation: 3.6, 3.7, 3.8, 7.2, 7.7 and 7.8.

Paragraph 3.6 is the most relevant:
"3.6 Hold Harmless.
PPH agrees, to the extent permissible under the Local Health Care District Law, California Health and Safety Code, § 32000, et seq., to indemnify, hold harmless, and provide and pay all costs for a defense for the City, with legal counsel of the City’s choice at professionally reasonable rates, in any legal action filed in a court of competent jurisdiction by a third party challenging the validity of this Agreement. The provisions of this Section shall not apply to the extent such damage, liability, or claim is proximately caused by the intentional or negligent act or acts of the City, its officers, agents, employees, orrepresentatives."

My view is that the City will be indemnified for actions challenging the validity of the ERTC Development Agreement. However, the City is exposed to damages, liability and claims caused by acts of the City. The agreement appears to be silent on the City's exposure based on acts by PPH or other parties.

I did not find any language related to the City's Liability in the three remaining documents.